污染环境下新型复合补片和生物补片修补犬腹壁缺损的比较研究

目的 比较胶原蛋白与聚丙烯(polypropylene,PP) 制作的复合补片和两种生物补片的特点及其应用于污染伤口一期修补的可行性.方法 成年雄性普通犬24 只,体质量16-20kg,在同一只动物上、左、右腹部建立三个污染缺损模型,将3 种补片随机置入同一只犬的3 个腹壁缺损进行修补.将3 种补片分为3 组:PP/ 胶原复合补片组(A 组),猪交联生物补片组(B 组),牛交联生物补片组(C 组).在实验犬的腹壁建立腹壁疝模型后,提取一段小肠,注入10ml 0.9% 氯化钠注射液后回抽,获得污染源,然后对腹腔,切口和补片进行污染,根据分组将5cm×5cm 的补片关闭腹壁缺损.术后90d 处死实验犬,大体观察腹腔脏器粘连情况,切取补片及其周围组织进行组织学观察.结果 术后90d 无实验动物死亡;术后各组均发生了补片网膜粘连.组织学观察,纤维增生情况,炎性反应情况及新生血管情况A 组补片的评分均高于B,C 组补片.结论 在污染环境下,新型PP/ 胶原蛋白复合补片在预防粘连方面同生物补片有相同效果,在炎性反应、纤维增生和新生血管形成方面均较生物补片严重.

New composite patches and biologic patches for repair of contaminated abdominal wall defect in dogs: A comparative study

Objective To compare the characteristics of two compound patches made of collagen and polypropylene(PP) and the feasibility of their application in repair of contaminated wounds.Methods Twenty-four adult male dogs,weighing 16-20kg,were included in this study.A dog model with 3 contaminated defects at the upper,left and right abdominal wall was established.The 3 abdominal wall defects were repaired by implanting 3 kinds of patches into them.The patches were divided into PP and collagen compound patch group(group A),porcine cross-linked biologic patch group(group B),and cattle cross-linked biologic patch group(group C).A dog abdominal hernia model was established.A segment of small intestine was removed,into which 10ml 0.9% sodium chloride solution was injected and then aspirated to contaminate the abdominal cavity,abdominal wall and patches.The abdominal wall defects were closed with 5cm×5cm patches.The dogs were killed on day 90 after operation to observe the adhesion of organs in abdominal cavity.The patches and their adjacent tissue were cut into sections for histological study.Results No death occurred while patch and omentum adhesion was observed in different groups 90 days after operation.Histological study showed that the scores of proliferating fibroblasts,inflammatory reaction and formation of new blood vessels were higher in group A than in groups B and C.Conclusion The effect of PP and collagen compound patch and biological patch is similar in preventing adhesion under contaminated environment.However,it leads to severer proliferation of fibroblasts,inflammatory reaction and formation of new blood vessels than biologic patch.