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扩展聚四乙烯网在胸壁重建:一个27年的经验
Aida K Sarcon1, Omar A Selim2, Barbara L Mullen3
1Division of General Surgery, Department of Surgery, Mayo Clinic, Rochester, Minn.
The Journal of thoracic and cardiovascular surgery
|June 15, 2024
概括
扩展的聚四乙烯网格对于胸壁重建是有效的,大多数患者获得稳定的结果. 然而,肥胖,较大的缺陷和先前的辐射增加了网状相关事件的风险,主要是感染.
科学领域:
- 胸部外科手术 胸部外科手术
- 生物材料科学是生物材料的科学.
- 手术成果研究的研究结果.
背景情况:
- 胸壁缺陷通常需要重建以恢复结构完整性和功能.
- 扩展聚四乙烯 (ePTFE) 网是一种用于各种手术应用的合成材料,包括胸壁修复.
研究的目的:
- 评估使用扩展聚四乙烯 (Gore-Tex) 网格用于胸壁重建的成功和并发症.
- 用ePTFE网进行胸壁重建的患者中,识别与网状相关事件相关的风险因素.
主要方法:
- 通过使用扩展聚四乙烯网格进行胸壁重建的患者的回顾性审查.
- 作为主要结果,分析与网状组织相关的事件,包括针对感染或脱菌的重新手术.
- 统计分析以确定与网格相关并发症的预测因素.
主要成果:
- 在246次重建中,22.4%的患者经历了与网状组织相关的事件,感染是需要重新手术的最常见并发症.
- 以前的胸壁辐射,更高的体重指数 (肥胖) 和更大的缺陷大小是与网状相关事件的显著预测因素.
- 88%的受感染的网格需要完整的探索,只有8.3%需要随后的网格放置.
结论:
- 扩展聚四乙烯网格在大多数患者 (78%) 中平均4年后提供稳定的胸壁重建.
- 肥胖,大缺陷和先前的辐射等危险因素需要仔细选择患者和进行手术规划.
- 虽然可以发生网状感染,但经验丰富的外科医生可以有效地管理它们,通常不需要更换网状.
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