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上层可吸收生物合成与下层生物网腹 Hernia 修复在受污染的领域

Chris Amro¹, Jane N Ewing², Dominic J Romeo²

¹Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania; Hansjörg Wyss Department of Plastic Surgery, NYU Langone, New York, New York.

The Journal of surgical research

|January 5, 2025

概括

可再吸收的生物合成网格可能比生物网格更好,用于受污染的腹修复 (VHR) 与腹壁重建 (AWR). 生物合成网显示了较少的手术场所发生和干预,可能降低了患者的负担.

科学领域:

腹部外科手术腹部外科手术
生物材料科学是生物材料的科学.
Hernia 修复 Hernia 修复的方法

背景情况:

受到污染的腹壁重建 (AWR) 与腹修复 (VHR) 提出了重大的手术挑战.
在这些复杂的情况下,选择网状材料和放置技术至关重要.
将可再吸收的生物合成网格与底层生物网格进行比较,对于优化结果至关重要.

研究的目的:

为了评估在被AWR污染的VHR中,上层可再吸收的生物合成网格与底层生物网格的有效性.
为了比较并发症率,包括手术部位发生率 (SSO) 和复发率.
评估网格选择对受污染的外科领域患者结果的影响.

主要方法:

2015年至2021年在受污染领域 (CDC伤口II-IV类) 接受VHR与AWR的患者的单一中心回顾性审查.
匹配配对分析,根据患者人口统计和伤口分类,将可再吸收的生物合成网格 (上层) 与生物网格 (底层) 进行比较.
评估结果,包括SSO,SSO干预的需要,以及的复发.

主要成果:

分析了94名患者 (每组47名),生物合成网格组显著减少了SSO (46.8%与72.3%,P <0.05) 和SSO干预 (19.1%与38.4%,P <0.05).
虽然生物合成网格组的复发数量较少 (14.9%对30.4%),但这种差异在统计学上并不显著 (P = 0.07).
该研究包括了缺陷大小,组分分离率高,大多数是干净受污染的伤口的患者.

结论:

可再吸收的生物合成网格在被AWR污染的VHR中可能比生物网格具有优势,从而减少了手术部位的发生.
与生物合成网相关的SSO和干预率较低可以减少术后临床和财务负担.
进一步的调查可能是有必要的,以证实的复发率在统计学上显著减少.

关键词:

腹壁的重建腹壁的重建受污染的田地被污染了可再吸收的生物合成网格.手术部位发生的情况.腹腔 Hernia 修复腹腔的修复

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