Bellón J M, Buján J, Contreras L A, Carreras-San Martín A, Hernando A, Jurado F
Department of Morphological Sciences and Surgery, University of Alcalá de Henares, Madrid, Spain.
Biomaterials. 1996 Jul;17(13):1265-71. doi: 10.1016/s0142-9612(96)80002-0.
We studied the behaviour of the different tissue interfaces formed on a new type of prosthesis used for the repair of abdominal wall defects, Mycro Mesh (W. L. Gore and Ass., Flagstaff, AZ, USA), which consists of perforated layers of polytetrafluoroethylene (PTFE). In 20 New Zealand white rabbits, a full-thickness (except skin) 7 cm x 5 cm defect was created in the anterior abdominal wall. The defects were repaired with a prosthetic implant (Mycro Mesh) that was placed in direct contact with abdominal viscera and subcutaneous tissue. At 14, 30, 60 and 90 d post-implantation, samples were obtained from the tissue interfaces formed between the prosthesis and subcutaneous tissue, visceral peritoneum and receptor tissue, respectively. Samples were studied by optical microscopy and scanning electron microscopy. The immunohistological study was made with RAM-11, a monoclonal antibody specific for rabbit macrophages. Tensile strength was measured with an Instron tensiometer using 2 cm wide strips obtained parallel to the shorter axis of the implant. Strips included the prosthesis and two anchor zones on the receptor tissue. Macroscopically, the prosthesis induced little adhesion formation on the visceral peritoneum interface. Microscopically, an organized neoperitoneum and abundant tissue formed on the subcutaneous interface. In the prosthesis perforations, bridges of tissue linked the peritoneal and subcutaneous sides. The macrophage response decreased significantly in intensity between day 14 and day 90 (Student-Newman-Keuls test, P = 0.01). Tensile strength increased significantly (Wilcoxon test, P < 0.05) at every study period. To conclude: the Mycro Mesh prosthesis proved suitable for implantation in sites where it comes in contact with abdominal viscera and it provided good support for the formation of an organized neoperitoneum; the perforations in the prosthetic material improved implant integration; the macrophage response was not altered by the biomaterial and the tensile strength of the prosthesis increased as scar tissue formation and tissular integration of the prosthesis progressed.
我们研究了一种用于修复腹壁缺损的新型假体Mycro Mesh（美国亚利桑那州弗拉格斯塔夫市的W. L. Gore and Ass.公司生产）上形成的不同组织界面的行为，该假体由聚四氟乙烯（PTFE）穿孔层组成。在20只新西兰白兔的前腹壁制造一个全层（除皮肤外）7厘米×5厘米的缺损。用与腹腔脏器和皮下组织直接接触的假体植入物（Mycro Mesh）修复缺损。在植入后14、30、60和90天，分别从假体与皮下组织、内脏腹膜和受体组织之间形成的组织界面获取样本。样本通过光学显微镜和扫描电子显微镜进行研究。免疫组织学研究使用RAM - 11进行，RAM - 11是一种对兔巨噬细胞特异的单克隆抗体。使用Instron张力计测量拉伸强度，使用与植入物短轴平行获得的2厘米宽的条带。条带包括假体和受体组织上的两个锚定区。宏观上，假体在内脏腹膜界面诱导很少的粘连形成。微观上，在皮下界面形成有组织的新腹膜和丰富的组织。在假体穿孔处，组织桥连接腹膜和皮下侧。巨噬细胞反应强度在第14天和第90天之间显著降低（Student - Newman - Keuls检验，P = 0.01）。在每个研究时期拉伸强度显著增加（Wilcoxon检验，P < 0.05）。结论：Mycro Mesh假体被证明适合植入与腹腔脏器接触的部位，并且为有组织的新腹膜形成提供了良好的支撑；假体材料中的穿孔改善了植入物的整合；生物材料未改变巨噬细胞反应，并且随着瘢痕组织形成和假体组织整合的进展，假体的拉伸强度增加。
