Experimental study of the characteristics of a novel mesh suture.
Experimental study of the characteristics of a novel mesh suture.
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DOI：
10.1002/bjs.9853
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Dumanian ZP
中科院分区：
文献类型：
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作者：
Dumanian GA;Tulaimat A;Dumanian ZP
在疝修补术中，缝线无法保持组织贴壁已得到充分表征。设计用于促进组织整合到细丝内和细丝周围的网状缝线可改善组织固定并减少缝线拉穿。 在体外，比较了缝线在弹道凝胶中的抗拉穿性。在体内，使用两种缝线闭合11只雌性猪的中线剖腹手术切口。随后对组织片段进行机械和组织学试验。补片缝线的拉伸特性与0-聚丙烯缝线几乎相同。补片缝线表现出比标准缝线更大的抗拉强度（平均值（s.d.）4.27（0.42）对2.23（0.48）N; P <0.001）。在猪中，使用网状缝线修复的白线在第8天的极限拉伸强度较高（320（57）vs 160（56）N; P <0.001），失效功也较高（24.6（14.2）vs 7.3（3.7）J; P <0.001）和弹性（128（9）vs 72（7）N/cm; P <0.001）。第8天和第90天的组织学检查显示补片缝线完全组织整合。传统缝线具有在高张力闭合中切割和牵拉组织的显著缺点。具有柔性大孔外壁和中空芯的新型网状缝线设计允许组织生长到缝线中，提高早期伤口强度并减少缝线拉穿。该技术可显著提高高压闭合的可靠性，从而预防剖腹手术后切口疝。由于缝线拉穿是一个与所有外科学科相关的问题，因此设想了具有不同物理特性和材料的补片缝线配方的许多其他适应症。在实验模型中，新型网状缝线结构增加了早期伤口愈合的强度。 改善早期伤口强度
The failure of sutures to maintain tissue in apposition is well characterized in hernia repairs. A mesh suture designed to facilitate tissue integration into and around the filaments may improve tissue hold and decrease suture pull‐through. In vitro, the sutures were compared for resistance to pull‐through in ballistics gel. In vivo, closure of midline laparotomy incisions was done with both sutures in 11 female pigs. Tissue segments were subsequently subjected to mechanical and histological testing. The mesh suture had tensile characteristics nearly identical to those of 0‐polypropylene suture. Mesh suture demonstrated greater resistance to pull‐through than standard suture (mean(s.d.) 4·27(0·42) versus 2·23(0·48) N; P < 0·001) in vitro. In pigs, the ultimate tensile strength for repaired linea alba at 8 days was higher with mesh suture (320(57) versus 160(56) N; P < 0·001), as was the work to failure (24·6(14·2) versus 7·3(3·7) J; P < 0·001) and elasticity (128(9) versus 72(7) N/cm; P < 0·001) in comparison with 0‐polypropylene suture. Histological examination at 8 and 90 days showed complete tissue integration of the mesh suture. Traditional sutures have the significant drawback of cutting and pulling through tissues in high‐tension closures. A new mesh suture design with a flexible macroporous outer wall and a hollow core allows the tissues to grow into the suture, improving early wound strength and decreasing suture pull‐through. This technology may dramatically increase the reliability of high‐tension closures, thereby preventing incisional hernia after laparotomy. As suture pull‐through is a problem relevant to all surgical disciplines, numerous additional indications are envisioned with mesh suture formulations of different physical properties and materials. The novel mesh suture structure increased the strength of early wound healing in an experimental model. Improved early wound strength