Impact of polymer pore size on the interface scar formation in a rat model
Impact of polymer pore size on the interface scar formation in a rat model
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DOI：
10.1006/jsre.2002.6358
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发表时间：
2002-04-01
影响因子：
2.2
通讯作者：
Schumpelick, V
中科院分区：
文献类型：
--
作者：
Klinge, U;Klosterhalfen, B;Schumpelick, V
背景疝的外科治疗越来越多地基于用异体材料（特别是外科补片）加固。对这些异物的生物反应在很大程度上取决于所选材料及其结构。与简单腹壁切口后的生理瘢痕过程相比，聚合物界面处的慢性炎症导致特定的形态学改变。材料和方法在本研究中，将两种不同孔径的补片植入大鼠体内：一种是由不可吸收聚丙烯单丝制成的重型小孔径补片（hw-补片），另一种是由聚丙烯和可吸收polyglactin复丝制成的轻型大孔径补片（lw-补片）。剖腹手术的缝合修复作为对照。在7、14、21和90天后，分析补片面积的组织和细胞反应。在整个观察期内，形态测定分析表明lw补片的整合改善，炎症和纤维化减少，而hw补片诱导严重的慢性炎症，伴随着强化的桥接瘢痕反应。在细胞水平上，这些发现对应于升高的细胞更新，其特征在于凋亡和增殖细胞的速率增加。相比之下，对lw补片的组织反应达到的水平几乎与对照组的生理烧灼过程相似。结论。总之，当前数据证实了在hw补片和lw补片的界面处发生慢性炎症异物反应;但是，使用lw补片显示出上级组织整合。对于非常相似的聚合物表面，孔径似乎在组织反应和补片结构的生物相容性方面具有重要意义。(C)2002年爱思唯尔科学（美国）。
Background. The surgical therapy of hernias is increasingly based on reinforcement with alloplastic material, in particular surgical meshes. The biological response to these foreign bodies largely depends on the selected material and its structure. In comparison to the physiological scar process following a simple abdominal wall incision, the chronic inflammation at the interface to the polymers lead to specific morphological alterations.Materials and methods. In the present study two meshes with different pore sizes were implanted into rats: a heavy-weight and small-pore-sized mesh (hw-mesh) made of nonabsorbable polypropylene mono-filaments and a low-weight large-pore-sized mesh consisting of polypropylene and of absorbable polyglactin multifilaments (lw-mesh). A suture repair of a laparotomy served as control. After 7, 14, 21, and 90 days the mesh area was analyzed with regard to tissue and cellular response.Results. Over the whole observation period morphometric analysis indicated an improved integration of the lw-mesh with reduction of both inflammation and fibrosis, whereas the hw-mesh induced an intense chronic inflammation concomitant with an intensified bridging scar reaction. On the cellular level these findings correspond to an elevated cell turnover, characterized by increased rates of apoptotic and proliferating cells. In contrast, the tissue reaction to the lw-mesh achieved levels almost similar to those of the physiological searing process in the control group.Conclusion. In conclusion, the present data confirm the development of a chronic inflammatory foreign body reaction at the interface to both hw-meshes and lw-meshes; however, the use of lw-meshes showed superior tissue integration. With regard to the quite similar polymer surface the pore size appears to be of major importance in tissue reaction and for the biocompatibility of mesh structures. (C) 2002 Elsevier science (USA).