Alponat A, Lakshminarasappa S R, Yavuz N, Goh P M
Department of Surgery, National University Hospital, Singapore.
Am Surg. 1997 Sep;63(9):818-9.
Adhesion formation, which is almost inevitable following incisional hernia repair with prosthetic mesh, may lead to intestinal obstruction and enterocutaneous fistulae. Physical barriers, namely carboxymethylcellulose and hyaluronic acid, have been reported to lessen the intra-abdominal adhesions. To evaluate the effects of Seprafilm (Genzyme Corp., Cambridge, MA), a bioresorbable, translucent membrane composed of carboxymethylcellulose and hyaluronic acid, in the presence of a foreign body such as polypropylene mesh, an incisional hernia model in rats was used. Twenty-four male rats were divided into two groups: control (12) and Seprafilm (12). A defect, measuring 1.5 x 2.5 cm, was created in each animal. Control animals had the polypropylene mesh sutured to the defect, whereas in the other group, two membranes of Seprafilm were laid over the abdominal viscera before repair with polypropylene mesh. Half of the animals from each group were killed at postoperative day 7 and remaining half at day 30 for adhesion scoring and histological evaluation of wound healing. Seprafilm animals had fewer adhesions compared with control animals (P = 0.0008). Seprafilm had no adverse effect on wound healing. This membrane seems to have the potential to lessen the adhesion-related morbidity following incisional hernia repair.
使用人工合成补片进行切口疝修补术后几乎不可避免会形成粘连，这可能导致肠梗阻和肠皮肤瘘。据报道，物理屏障，即羧甲基纤维素和透明质酸，可减少腹腔内粘连。为了评估Seprafilm（健赞公司，马萨诸塞州剑桥）的效果，Seprafilm是一种由羧甲基纤维素和透明质酸组成的可生物吸收的半透明膜，在存在聚丙烯补片等异物的情况下，使用大鼠切口疝模型。将24只雄性大鼠分为两组：对照组（12只）和Seprafilm组（12只）。在每只动物身上制造一个1.5×2.5厘米的缺损。对照组动物将聚丙烯补片缝合到缺损处，而在另一组中，在用聚丙烯补片修复之前，将两片Seprafilm膜覆盖在腹腔脏器上。每组一半的动物在术后第7天处死，其余一半在第30天处死，用于粘连评分和伤口愈合的组织学评估。与对照组动物相比，Seprafilm组动物的粘连较少（P = 0.0008）。Seprafilm对伤口愈合没有不良影响。这种膜似乎有可能降低切口疝修补术后与粘连相关的发病率。
