S聚丙烯网片在污染切口应用的大鼠实验研究  

The feasibility study of Polypropylene mesh in pollution incision application

作　　者：赵亮[1] 苏拓[1] 张杰[1] 许铮[1] 刘凤阁[2] 刘彤[2] 王秀芳[2] 

机构地区：[1]北京市通州区潞河医院疝和腹壁外科,北京101100 [2]北京市通州区潞河医院病理科,北京101100

出　　处：《临床和实验医学杂志》2014年第17期1397-1399,共3页Journal of Clinical and Experimental Medicine

基　　金：首都卫生发展科研专项基金(201300192)

摘　　要：目的通过动物实验研究污染伤口植入聚丙烯网片后切口感染率和病理学变化,探讨嵌顿性腹股沟疝患者应用聚丙烯网片行疝修补术的可行性。方法大鼠分成3组,每组40只,分别为清洁植入网片组(A组)、大肠杆菌污染不植入网片组(B组)和大肠杆菌污染植入网片组(C组)。在大鼠左右背部切口3 cm,A组直接植入聚丙烯网片,B组应用大肠杆菌悬浊液污染切口30 min后0.25%稀释碘伏冲洗切口后局部用咽拭子浸蘸做细菌培养然后直接缝合,C组如B组处理后植入聚丙烯网片。术后观察A、B、C三组伤口愈合情况和感染率,并分别于术后1、2、4、8周取出网片作病理检查。结果所有实验动物无死亡。A组切口1期愈合,切口感染率为0;1周时网片网孔内已有纤维母细胞和纤维细胞增生,部分区域已有肉芽形成,8周时纤维细胞和胶原细胞已经排列规则致密;B、C组细菌培养无细菌生长;B组切口感染率7.5%(3/40),感染切口经引流换药2期愈合;C组切口感染率10.0%(4/40),未感染之网片较清洁切口之网片同期病理有较多巨噬细胞存在;感染切口未去除网片经引流换药2期愈合,术后8周取出网片作病理检查纤维细胞和胶原细胞较规则排列,有巨噬细胞存在。结论动物实验结果表明:切口污染状态下经稀释碘伏冲洗后,植入聚丙烯网片并不增加切口感染率。提示对于嵌顿性腹股沟疝甚至发生肠坏死行肠切除肠吻合患者可以应用聚丙烯网片行疝修补术。Objective To study contaminated wounds after implantation of polypropylene mesh in the incision by observing infection rate and pathology change,and to investigate the application feasibility of line polypropylene mesh hernia repair on patients with incarcerated inguinal hernia. Methods New Zealand rabbit is divided into three groups,each group included 40 rabbits respectively. Clean plant net group was defined as group A,escherichia coli contamination without planting the net was defined group B. And escherichia coli contamination plant net group was defined was group C. The incision on its back is about around 3 cm,directly into the polypropylene mesh in group A. E. coli suspension polluted incision after 30 minutes of 0. 25% dilute iodine volts,flushed incision after local dip in with pharyngeal swab,dipped to do bacterial culture and direct suture in group B. Similar with group B,polypropylene mesh was applied after treatment in group C. The postoperative observation of group A,B,C included wound healing and infection rates and in 1,2,4,8 weeks took mesh for pathologic examination. Results No death rabbits was reported in all experimental animals. The grade of incision healing in A group was 1 grade,the incision infection rate was 0%. mesh cell hyperplasia of fibroblasts and fiber,parts for granulation in the mesh was found at 1 week. Collagen fiber cells had dense arrangement rules at eight weeks. No bacteria culture no bacterial growth in B and C group was found. 3 /40 incision infection rate（ 7. 5%） was found in group B. The infection incision by switching phase was healed. 4 /40 incision infection rate（ 10%） was found in group C. The mesh of uninfected cleaner incision of the mesh in the same period showed more macrophages existing. Incision infection does not remove the mesh by the drainage treatment. The mesh for 8 weeks after pathologic examination and collagen fiber cells showed more rules,the presence of macrophages. Conclusion Pollution condition of incision after dilute iodine volts flushin

关 键 词：大鼠 污染伤口 聚丙烯网片 感染率 病理学 

分 类 号：R656.2[医药卫生—外科学]