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Improved tissue integration of a new elastic intraperitoneal stoma mesh prosthesis.
Journal of Biomedical Materials Research Part B: Applied Biomaterials ( IF 3.2 ) Pub Date : 2020-01-22 , DOI: 10.1002/jbm.b.34562
Roman Eickhoff 1 , Daniel Heise 1 , Andreas Kroh 1 , Marius Helmedag 1 , Uwe Klinge 1 , Ulf P Neumann 1 , Christian D Klink 1 , Andreas Lambertz 1
Affiliation  

Parastomal herniation is a frequent complication in colorectal surgery, occurring with a prevalence of 30–80%. The aim of the study was to create a new intraperitoneal colostoma mesh prosthesis (IPST) with enhanced elastic properties made with thermoplastic polyurethane (TPU) monofilaments. We performed open terminal sigmoid colostomies reinforced with either a 10 cm by 10 cm polyvinylidene fluoride (PVDF) or a new TPU/PVDF composite mesh in a total of 10 minipigs. Colostoma was placed paramedian in the left lower abdomen and IPST meshes were fixed intraperitoneal. After 8 weeks, the animals were euthanized after laparoscopic exploration and specimen were explanted for histological investigations. Implantation of a new IPST‐mesh with enhanced elastic properties was feasible in a minipig model within an observation period of 8 weeks. Immunohistochemically, Collagen I/III ratio as a marker of tissue integration was significantly higher in TPU‐group versus PVDF group (9.4 ± 0.5 vs. 8.1 ± 0.5, p = 0.002) with a significantly lower inflammatory reaction measured by a smaller inner granuloma at mesh–colon interface (17.6 ± 3.3 μm vs. 23 ± 5 μm, p < 0.001). A new TPU/PVDF composite mesh with enhanced elastic properties as IPST was created. Stoma surgery and especially the evaluation of the new stoma mesh prosthesis are feasible with reproducible results in an animal model. Tissue integration expressed by Collagen I/III ratio seems to be improved in comparison to standard‐elastic PVDF‐IPST meshes.

中文翻译:

改进了新型弹性腹膜内造口网状假体的组织整合。

造口旁疝是结直肠手术中常见的并发症,发生率为 30-80%。该研究的目的是创造一种新的腹腔内结肠造口网状假体 (IPST),具有增强的弹性,由热塑性聚氨酯 (TPU) 单丝制成。我们对总共 10 只小型猪进行了用 10 cm x 10 cm 聚偏二氟乙烯 (PVDF) 或新型 TPU/PVDF 复合网增强的开放式末端乙状结肠造口术。将结肠造口放置在左下腹部旁正中,并在腹膜内固定 IPST 网。8周后,腹腔镜探查后对动物实施安乐死,并取出标本进行组织学研究。在 8 周的观察期内,在小型猪模型中植入具有增强弹性的新型 IPST 网是可行的。p = 0.002),通过网状结肠界面处较小的内部肉芽肿测量的炎症反应显着降低(17.6 ± 3.3 μm vs. 23 ± 5 μm,p < 0.001)。创建了一种新的 TPU/PVDF 复合网,具有增强的 IPST 弹性。造口手术,尤其是新造口网状假体的评估是可行的,在动物模型中具有可重复的结果。与标准弹性 PVDF-IPST 网格相比,由胶原 I/III 比率表示的组织整合似乎得到了改善。
更新日期:2020-01-22
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