Biocompatibility of bacterial contaminated prosthetic meshes and porcine dermal collagen used to repair abdominal wall defects
Biocompatibility of bacterial contaminated prosthetic meshes and porcine dermal collagen used to repair abdominal wall defects
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DOI：
10.1007/s00423-006-0080-2
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发表时间：
2007-07-01
影响因子：
2.3
通讯作者：
Koeckerling, F.
中科院分区：
文献类型：
--
作者：
Ott, R.;Hartwig, T.;Koeckerling, F.
背景与目的
污染或感染的手术部位被视为使用用于修复腹壁缺损的不可吸收的异体材料的禁忌证。因此，对新型假体材料的生物相容性进行了研究。
材料与方法
采用镶嵌技术，将由常规的及钛涂层的聚丙烯、聚乙二醇或猪真皮胶原蛋白制成的1.5×1.5厘米的网片植入96只大鼠（8组，每组12只动物）的腹壁下。在半无菌条件下以及网片被细菌污染的情况下，对所有4种材料均进行了植入。28天后取出网片。
结果
在半无菌条件下植入的所有材料都整合到腹壁中，仅有少量腹腔内粘连（平均粘连评分分别为1.0、1.2、1.0、0.8分，无显著差异）。对于猪真皮胶原蛋白，增殖率和炎症细胞比例在统计学上较低（p < 0.01）。在细菌污染组，所有网片都伴有化脓性感染以及肠道和网片之间的强烈粘连，在真皮胶原蛋白的情况下最为显著（平均粘连评分分别为1.6、1.7、1.7和1.9分，无显著差异）。在该组中，有2只动物死于腹膜炎。与其他材料相比，增殖率显著升高（p = 0.03）。所使用的其他材料之间未观察到显著差异。
结论
无论使用何种材料，在被细菌污染的腹壁中植入异体网片都会伴有化脓性感染，特别是在膜状猪真皮胶原蛋白的情况下。因此，不可吸收的异体网片和真皮皮肤移植物不应用于修复感染的腹壁缺损。
Background and aims A contaminated or infected surgical site is considered a contraindication for the use of the nonabsorbable alloplastic materials employed to repair abdominal wall defects. Therefore, the biocompatibility of new prosthetic materials was investigated.Materials and methods Meshes measuring 1.5x1.5 cm made of conventional and titanium-coated polypropylene, polyglycol, or porcine dermal collagen were implanted under the abdominal wall of 96 rats (eight groups of 12 animals each) employing the inlay technique. Implantation of all four materials was performed both under semisterile conditions and bacterial contamination of the mesh. The meshes were explanted after 28 days.Results All the materials implanted under semisterile conditions were incorporated into the abdominal wall with only few intraabdominal adhesions (mean adhesion scores: 1.0, 1.2, 1.0, 0.8 points, respectively, not significant). With the porcine dermal collagen, proliferation rate and the proportion of inflammatory cells were statistically lower (p < 0.01). In the bacterial contamination group, all meshes were associated with a suppurating infection and strong adhesions between the bowel and mesh, which were most prominent in the case of dermal collagen (mean adhesion scores: 1.6, 1.7, 1.7, and 1.9 points, respectively, not significant). In this group, two animals died of peritonitis. In comparison with the other materials, the proliferation rate was significantly elevated (p=0.03). No significant differences were seen between the other materials employed.Conclusion Irrespective of the material employed, implantation of alloplastic meshes in an abdominal wall contaminated with bacteria, is associated with suppurating infections, in particular in the case of the membrane-like porcine dermal collagen. Nonabsorbable alloplastic meshes and dermal skin grafts should therefore not be used to repair infected abdominal wall defects.