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中华疝和腹壁外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (01) : 25 -30. doi: 10.3877/cma.j.issn.1674-392X.2025.01.005

综述

不同疝补片对伤口愈合胶原蛋白沉积的影响
黄雨琳1, 嵇振岭1,()   
  1. 1.210009 南京,东南大学附属中大医院普外科
  • 收稿日期:2024-01-03 出版日期:2025-02-18
  • 通信作者: 嵇振岭

Effect of different hernia patches on collagen deposition in wound healing

Yulin Huang1, Zhenling Ji1,()   

  1. 1.Department of General Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2024-01-03 Published:2025-02-18
  • Corresponding author: Zhenling Ji
引用本文:

黄雨琳, 嵇振岭. 不同疝补片对伤口愈合胶原蛋白沉积的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(01): 25-30.

Yulin Huang, Zhenling Ji. Effect of different hernia patches on collagen deposition in wound healing[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(01): 25-30.

腹壁疝作为腹部外科常见的疾病之一,常常因为腹腔内脏器脱出而引起疼痛,甚至嵌顿导致脏器坏死等严重后果,故而多需要行手术治疗。其根本病因是腹壁薄弱,胶原蛋白失衡或者产生异常胶原纤维都将导致腹壁结缔组织的削弱、变薄,进而导致疝的发生及复发。大量研究已表明筋膜组织中Ⅰ型/Ⅲ型胶原蛋白的比例失调是导致腹股沟疝的主要因素。已有研究证明伤口愈合胶原蛋白沉积受补片类型的显著影响,然而,到目前为止,还没有研究调查不同移植材料对人体筋膜中胶原蛋白沉积和组织重塑的作用。本文归纳3 类(不可吸收补片,生物补片,人工合成的可吸收补片)疝补片对胶原蛋白的沉积所带来的影响。

As one of the common diseases in abdominal surgery, abdominal wall hernia often causes pain caused by the prolapse of the abdominal cavity organs, and even causes serious consequences such as organ necrosis, so more surgical treatment is needed.The fundamental reason for this is that a weak abdominal wall, collagen imbalance, or abnormal collagen fibers can lead to weakening and thinning of the connective tissue of the abdominal wall, which in turn can lead to the development and recurrence of hernias.Numerous studies have shown that the proportional dysregulation of type I / typeⅢ of collagen in the fascial tissue is the main factor involved in the inguinal hernia.It has been demonstrated that wound-healing collagen deposition is significantly affected by patch type , however, to date, no studies have investigated the role of different graft materials on collagen deposition and tissue remodeling in the human fascia.This article summarizes the effects of 3 types of hernia patches (non-absorbable patches,biological patches, and synthetic absorbable patches) on collagen deposition.

表1 不同补片的特点对比
补片 名称 公司 特征 组成 总结
不可吸收补片 Surgipro® Tyco Healthcare,Mansfield,MA 重量:85g/m2孔表面积:(0.26±0.03)mm2 PP-HW (1)孔表面积大于3mm2促进Ⅰ型和Ⅲ型胶原的合成;(2)孔表面积较大的PP-LW诱导更多的Ⅲ型胶原沉积,并更快地转化为Ⅰ型胶原;(3)最大孔表面积的PP-LW(Optilene Elastic®),在植入后14d表现出拉伸强度强于孔表面积较小的PP-LW;(4)就胶原沉积来说,聚丙烯补片总是多于其它不可吸收补片
Marlex® Cirúrgica Brasi 重量:100g/m2平均孔隙:0.8mm PP-HW
Parietene® Tyco Healthcare,Mansfield,MA 重量:38g/m2孔表面积:(1.15±0.05)mm2 PP-LW
Ultrapro® Ethicon,Johnson&Johnson,Somenville,NJ 重量:28g/m2孔表面积:(3.45±0.19)mm2 PP-LW
Optilene Elastic® B.Braun,Melsungen,Germany 重量:48g/m2孔表面积:(7.64±0.32)mm2 PP-LW
可吸收补片 人工合成 Vicryl Woven Mesh Johnson&Johnson Gateway,NewBrunswick,NJ (-) 聚半乳糖蛋白-910 (1)生物补片在胶原蛋白沉积,组织和新生血管形成方面优于人工合成的可吸收补片;(2)非交联猪源(Surgisis)、非交联人源的生物补片(AlloDerm)在胶原沉积上无明显差异;(3)非交联人源的生物补片(AlloDerm)和非交联猪源的生物补片(Surgisis、Strattice)比交联猪源补片(Permacol)更好的重塑特征
AlloDerm Lifecell,Branchburg,NJ 人体皮肤组织 非交联基底膜复合物和胶原纤维
生物补片 Surgisis Gold Cook Surgical,Bloomington,IN 猪小肠黏膜下层 非交联胶原蛋白(Ⅰ型、Ⅲ型和Ⅴ型)、糖胺聚糖、蛋白聚糖、糖蛋白和多种生长因子
Permacol Tissue ScienceLaboratory,Covington,GA,USA 猪小肠黏膜下层 无细胞交联真皮基质
Strattice LifeCell Corporation;Branchburg,NJ 猪真皮支架 交联真皮基质
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