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首页> 美国卫生研究院文献>American Journal of Translational Research >Treatment of de-peritonealized intestine with 4DryField® PH prevents adhesions between non-resorbable intra-peritoneal hernia mesh and bowel
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Treatment of de-peritonealized intestine with 4DryField® PH prevents adhesions between non-resorbable intra-peritoneal hernia mesh and bowel

机译：用4DryField®PH治疗去腹膜化的肠子可防止不可吸收的腹膜内疝气网和肠之间的粘连

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Background: Intraperitoneal onlay meshes (IPOM) can be associated with intestine-to-mesh adhesion formation, implementing risks like pain, enterocutaneous fistula, infection, and female infertility. This study investigates, whether a treatment of impaired intestinum with the anti-adhesive and hemostyptic agent 4DryField® PH prevents adhesion formation. Methods: In 20 male LEWIS rats uncoated polypropylene meshes were sewn to the inner abdominal wall and the cecum of the respective animal was de-peritonealized by peritoneal abrasion by a gauze swap, and meso-sutures ensured a constant contact of injured areas. Rats were treated with 4DryField® PH gel either premixed or applied as a powder with in-situ transformation (100 mg powder plus 0.4 ml 0.9% saline solution). One week postoperatively, the extent of intestine-to-mesh adhesions and the quality of mesh ingrowth were evaluated macroscopically by two independent investigators using two scoring systems. Furthermore, specimens were analysed microscopically. All data were compared with control animals without 4DryField® PH treatment and analysed statistically using student’s t-test. Results: Treatment of de-peritonealised cecum with 4DryField® PH significantly reduced intestine-to-mesh adhesions in both treatment groups as compared to controls without 4DryField® PH treatment (68% reduction with premixed gel, P<0.0001; 80% reduction with in-situ gel, P<0.0001). There was no impact on the quality of mesh ingrowth, confirmed histologically by a single-layer mesothelial coverage. Conclusion: These experiments mimick clinical IPOM implantation scenarios with adjacent bowel depleted from peritoneum. 4DryField® PH gel treatment resulted in intestinal mesothelial surface recovering without development of bowel-to-mesh adhesions. Concurrently, integration of mesh into the abdominal wall is undisturbed by 4DryField® PH treatment.
机译：背景：腹膜上覆盖网片（IPOM）可能与肠网粘连形成有关，并带来疼痛，肠胃瘘，感染和女性不育等风险。本研究探讨了用抗粘连和止血剂4DryField ® PH治疗肠受损的患者是否可以防止粘连的形成。方法：在20只雄性LEWIS大鼠中，将未涂覆的聚丙烯网片缝合到腹腔内壁，并通过纱布更换腹膜擦去盲肠的盲肠，并用中缝缝合线确保接触受伤部位。用预混合的或以具有原位转化的粉末形式使用的4DryField ® PH凝胶处理大鼠（100毫克粉末加0.4毫升0.9％盐溶液）。术后一周，由两名独立的研究人员使用两个评分系统对肉眼对肠与网的粘连程度和网状向内生长的质量进行了宏观评估。此外，对标本进行了微观分析。将所有数据与未经4DryField ® PH处理的对照动物进行比较，并使用学生t检验进行统计分析。结果：与未进行4DryField ® PH治疗的对照组相比，使用4DryField ® PH治疗去腹膜盲肠在两个治疗组中均显着降低了肠粘膜粘连用预混凝胶还原，P <0.0001;用原位凝胶还原80％，P <0.0001）。组织学证实单层间皮覆盖对网状长入的质量没有影响。结论：这些实验模仿了腹膜腔耗尽的邻近肠的临床IPOM植入方案。 4DryField ® PH凝胶处理可恢复肠间皮表面，而不会形成肠网粘连。同时，通过4DryField ® PH处理，网状结构整合入腹壁不受干扰。

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