应用聚丙烯和e-PTFE复合补片修补腹壁巨大切口疝  

Polypropylene and e-PTFE composite mesh for repair of huge incisional hernia

作　　者：张伟[1] 石恒明[1] 龚鼎铨[1] 杜宽航[1] 

机构地区：[1]上海第二医科大学附属第九人民医院外科,上海200011

出　　处：《外科理论与实践》2004年第4期347-349,共3页Journal of Surgery Concepts & Practice

摘　　要：目的回顾性分析应用聚丙烯和e鄄PTFE复合补片修补腹壁巨大切口疝的效果,介绍腹腔内应用复合补片的方法和经验。方法1999年5月至2003年12月应用复合补片修补腹膜难以对合的腹壁巨大缺损22例,其中补片置于皮下12例,腹腔内10例。平均随访期39个月。结果手术后切口并发症的发生率为41%(9/22),1例修补术后复发,占4.6%。应用皮下法发生切口感染3例,其中1例因严重感染而将补片取出;切口处皮下积液2例。应用腹腔内法者中仅2例发生切口皮下少量积液。结论腹壁巨大切口疝,特别是难以关闭腹膜的病例,可应用聚丙烯和e鄄PTFE复合补片进行修补。应用腹腔内置补片法并辅以正确的术后处理可使局部并发症明显减少。Objective To review the results of repairing huge incisional hernia by aid of a polypropylene and expanded polytetrafluoroethylene (e-PTFE) composite mesh, laying emphasis on applying the composite mesh intraperitoneally. Methods Huge abdominal wall defects twenty-two cases of, in which the peritoneum was difficult to close, were repaired by a polypropylene and e-PTFE composite mesh from 1999 to 2003. The mesh was placed subcutaneously in 12 cases and intraperitoneally in 10 cases. The average follow-up time was 39 months. Results Major postoperative wound complications occurred in 9 patients (41%). Recurrence of hernia occurred in one patient (4.6%). When the mesh was placed, seroma developed under the skin in 2 patients; wound infection occurred in 5 patients, in one of which the mesh was eventually removed. By contrast, there were only 2 patients with development of a light seroma when the mesh was placed intraperitoneally. Conclusions Huge incisional hernias, especially those in which reperitonealization is not possible, could be repaired by using a polypropylene and e-PTFE composite mesh. It is proposed to apply the mesh intraperitoneally with careful postoperative treatment.

关 键 词：切口疝 复合补片 修补术 

分 类 号：R656.2[医药卫生—外科学]