中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (25): 4579-4582.doi: 10.3969/j.issn.1673-8225.2011.25.006

• 膜生物材料 membrane biomaterials • 上一篇    下一篇

NaOH消蚀法制备脱细胞真皮基质修补腹壁疝

王  军1，张宝良1，袁庆鑫1，米立国2   

  1. 1河北医科大学附属唐山工人医院普通外科，河北省唐山市  063000
    2河北医科大学解剖学教研室，河北省石家庄市  050017
  • 收稿日期:2011-01-06 修回日期:2011-05-04 出版日期:2011-06-18 发布日期:2014-01-10
  • 通讯作者: 米立国，教授，河北医科大学解剖学教研室，河北省石家庄市 050017
  • 作者简介:王军★，男，1971年生，河北省唐山市人，汉族，2008年河北医科大学毕业，硕士，副主任医师，主要从事普通外科临床工作。 junw1971@yahoo.cn
  • 基金资助:

    河北省卫生厅科研基金(04106)。

Acellular dermal matrix prepared by NaOH-maceration for ventral hernia repair

Wang Jun1, Zhang Bao-liang1, Yuan Qing-xin1, Mi Li-guo2   

  1. 1Department of General Surgery, Tangshan Workers’ Hospital Affiliated to Hebei Medical University, Tangshan  063000, Hebei Province, China
    2Department of Anatomy, Hebei Medical University, Shijiazhuang  050017, Hebei Province, China
  • Received:2011-01-06 Revised:2011-05-04 Online:2011-06-18 Published:2014-01-10
  • Contact: Mi Li-guo, Professor, Department of Anatomy, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
  • About author:Wang Jun★, Master, Associate chief physician, Department of General Surgery, Tangshan Workers’ Hospital Affiliated to Hebei Medical University, Tangshan 063000, Hebei Province, China junw1971@yahoo.cn
  • Supported by:

    Science and Technology Foundation of Hebei Health Bureau, No. 04106*

PDF

329

被引次数

5

摘要：

背景：与其他疝修补材料相比，脱细胞真皮基质具有易血管化、抗感染、从而可用替代传统补片用于感染腹壁缺损重建等特点。
目的：观察NaOH消蚀法制备的脱细胞真皮基质作为修补材料应用于腹疝的应用价值。
方法：以全厚猪皮制成脱细胞真皮基质，45只SD雄性大鼠制备腹壁疝模型，随机数字表法分为腹壁疝组：直接缝合皮肤，Marlex网组和脱细胞真皮基质组：分别应用大小为3.5 cm×4.0 cm的Marlex网和脱细胞真皮基质缝合皮肤；观察修复后1周时有无腹壁疝发生，脱细胞真皮基质组修复后1，2，3，5，10周分别取材，其中每周各组取4只用于苏木精-伊红染色，光镜观察。修复后第5周Marlex网组和脱细胞真皮基质组各取6只用于抗张力试验。
结果与结论：术后1周脱细胞真皮基质组与Marlex网组腹壁疝发生率均显著低于腹壁疝组(P < 0.001)。脱细胞真皮基质的胶原纤维无明显变化，即有少量成纤维细胞植入，术后2周可见新生血管，术后5周脱细胞真皮基质内部血管密度基本稳定。将单独脱细胞真皮基质片与Marlex网行抗张力试验，Marlex网的抗张力显著高于脱细胞真皮基质(P < 0.001)。但植入体内5周后，脱细胞真皮基质筋膜组织的抗张力高于Marlex-筋膜组织(P < 0.05)。提示复合消蚀制备的脱细胞真皮基质可以作为良好的疝修补材料。

关键词: 脱细胞真皮基质, 脱细胞真皮基质-筋膜组织, 疝, 修补材料, NaOH消蚀法, 生物材料

Abstract:

BACKGROUND: The use of an acellular dermal matrix (ADM) may represent a new alternative to prosthetic mesh products.
OBJECTIVE: To study the value of porcine ADM made by NaOH-maceration as ventral hernia-repairing material.
METHODS: ADM was made from the full thick skin of the back of swines by NaOH-maceration. Forty-five male SD rats were randomly divided into three groups including ventral hernia group (n=7), ADM group (the ventral hernia repaired by 3.5 cm× 4.0 cm ADM, n=28) and Marlex mesh group (the ventral hernia repaired by 3.5 cm×4.0 cm Marlex mesh, n=10). The occurrence of ventral hernia was observed postoperatively 1 week. To evaluate ADM histology, 4 rats in ADM group were sacrificed at 1, 2, 3, 5 and 10 weeks after surgery respectively; 6 rats were respectively selected from the Marlex group and ADM group for the experiment of tension resistance at 5 weeks after surgery.
RESULTS AND CONCLUSION: The occurrence of ventral hernia in ADM group and Marlex mesh group was significantly lower than that of ventral hernia group 1 week after surgery (P < 0.001), but there was no difference between ADM group and Marlex mesh group(P > 0.05). The collagen of ADM did not change much after implantation. ADMs became infiltrated with little fibroblasts by 1 week after surgery. New wessels in ADMs were found by 2 weeks after surgery. The vessel density of ADMs kept stable by 5 weeks after surgery. The Marlex had a significantly higher breaking strength than that of the ADM (P < 0.001). But 5 weeks after surgery, the tension resistance of ADM-fascial interface was higher than that of the Marlex-fascial interface (P < 0.05). ADM prepared by the maceration of NaOH can be used as the material repairing ventral hernia.

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