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Influence of mesh structure on surgical healing in abdominal wall hernia repair

机译:网眼结构对腹壁疝修复手术愈合的影响

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Synthetic surgical mesh has become an important tool in the armamentarium of the surgeon reconstructing soft tissue defects and hernias. Mechanical failure and recurrence remain primary causes of repair revision and mesh removal in hernia repair. This study evaluated the qualitative and quantitative morphology of intramesh fibrous connective tissue (FCT) healing in a range of clinically used knitted (polypropylene and polyester) and non-woven (polypropylene) barrier and non-barrier surgical meshes implanted in a rabbit model. The results demonstrated that the knitted mesh displayed intramesh FCT healing that was concentric to the mesh fibers with significant between fiber FCT discontinuities due to the presence of adipose tissue. Non-woven surgical mesh resulted in a more linearly oriented intramesh FCT healing, primarily parallel to the plane of the non-woven mesh, with minimal FCT discontinuity. Non-woven surgical mesh had a significantly reduced incidence of FCT discontinuity and a higher probability of a FCT response than knitted surgical mesh. The presence of significant discontinuities in intramesh FCT healing in this study, especially in lightweight knitted surgical mesh which has been associated with mechanical failures clinically, underscores the importance of complete FCT healing for secure long term hernia repair. In conclusion, non-woven monofilament constructions of barrier and non-barrier surgical mesh resulted in highly congruent intramesh FCT healing when compared to commonly used barrier and non-barrier knitted surgical mesh constructions which demonstrated significant FCT healing discontinuities.
机译:合成外科网格已成为外科医生重建软组织缺陷和疝气的武器中的重要工具。机械衰竭和复发仍然是修复修复和疝气修复网眼移除的主要原因。该研究评估了在一系列临床用针织(聚丙烯和聚酯)和非织造(聚丙烯)屏障和植入兔模型中的非织造(聚丙烯)屏障和非屏障外科网格中的鞘内纤维结缔组织(FCT)愈合的定性和定量形态。结果表明,由于存在脂肪组织的存在,针织网格显示出与纤维FCT不连续性之间具有显着性的网状纤维的同心。无纺布外科网格导致更具线性定向的内部腔内愈合,主要平行于非织造网格的平面,具有最小的FCT不连续性。无纺布外科网格具有显着降低的FCT不连续性的发病率,而FCT响应的概率高于针织外科啮合。在本研究中存在显着不连续性的不连续性,特别是在临床上与机械故障相关的轻质针织外科滤网,强调了完全FCT愈合对安全长期疝气修复的重要性。总之,与常用的屏障和非屏障针织外科啮合结构相比,屏障和非屏障外科屏障的无纺布单丝构造是高度一致的缺口FCT愈合,其表现出显着的FCT愈合不连续性。

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