Functional and morphological evaluation of a low-weight, monofilament polypropylene mesh for hernia repair
Functional and morphological evaluation of a low-weight, monofilament polypropylene mesh for hernia repair
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DOI：
10.1002/jbm.10119
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发表时间：
2002-04-01
期刊：
影响因子：
--
通讯作者：
Klosterhalfen, B
中科院分区：
文献类型：
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作者：
Klinge, U;Junge, K;Klosterhalfen, B
全世界每年有超过100万例疝修补术，补片修补术已成为治疗疝的标准手术。除了各种技术问题外，材料类型已被证明对功能和组织学结果非常重要，特别是对于长期植入。尽管基于复丝的低重量、大孔补片的有利应用可以毫无疑问地陈述，但是基于纯单丝是否可以实现类似的结果仍然是开放的。在本研究中，将纯单丝制成的低重量聚丙烯补片（LW）与普通的重重量聚丙烯补片（HW）在功能后果和组织反应方面进行了比较。植入大鼠体内3 - 90天后，通过3D立体摄影术记录植入区域的腹壁活动度，并测量缝合区和补片的拉伸强度。关于炎性浸润、结缔组织、粒细胞、巨噬细胞和成纤维细胞数量的组织学反应的形态测定用于反映组织反应。作为界面处重塑过程的参数，通过TUNEL（分别为DNA链断裂或凋亡）、K! 67（细胞增殖）和HSP 70（细胞应激）。测量的LW补片拉伸强度证实了材料减少补片改良的足够强度。植入后，与HW补片相比，腹壁活动性的连续损伤减少，同时界面处的纤维化水平降低。在观察期结束时，LW补片的异物反应显著降低，几乎达到生理值。总之，这些数据证实了材料减少的补片植入物的生物相容性改善。(C)2002年John Wiley Sons，Inc.
With more than 1 million implantations per year worldwide, mesh repair has become a standard procedure for the treatment of hernias. Apart from various technical problems, the type of material has been proven to be of considerable importance for the functional and histological outcome, particularly for long-term implantation. Whereas the advantageous application of low-weight, large-pore meshes based on multifilaments can be stated without doubt, it is still open whether similar results can be achieved on the basis of pure monofilaments.In the present study, a low-weight polypropylene mesh (LW) made purely of monofilaments was compared to a common heavy-weight polypropylene mesh (HW) in regard to the functional consequences and the tissue response. After implantation in rats as an inlay for 3-90 days, the abdominal-wall mobility of the implant region was recorded by 3D stereography, and the tensile strength of both the suture zone and the mesh was measured. The morphometry of the histological reaction in regard to the inflammatory infiltrate, the connective tissue, the number of granulocytes, macrophages, and fibroblasts served to reflect the tissue response. As parameters for the remodeling process at the interface the cellular activation was evaluated by TUNEL (DNA-strand breaks or apoptosis, respectively), K! 67 (cell proliferation), and HSP 70 (cell stress). The measured tensile strength of the LW mesh confirmed a sufficient strength of the material-reduced mesh modification. After implantation the consecutive impairment of the abdominal-wall mobility was reduced compared to the HW mesh, concomitant to the reduced fibrotic level at the interface. At the end of the observation period the foreign-body reaction was significantly lowered for the LW mesh, almost reaching physiological values. In conclusion, these data confirm the improved biocompatibility of material-reduced mesh implants. (C) 2002 John Wiley Sons, Inc.