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首页> 外文期刊>Surgical Endoscopy >Remodeling characteristics and collagen distribution in synthetic mesh materials explanted from human subjects after abdominal wall reconstruction: An analysis of remodeling characteristics by patient risk factors and surgical site classifications
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Remodeling characteristics and collagen distribution in synthetic mesh materials explanted from human subjects after abdominal wall reconstruction: An analysis of remodeling characteristics by patient risk factors and surgical site classifications

机译：人体重建腹壁重建后的人造网状材料的重塑特征和胶原分布：通过患者危险因素和手术部位分类分析重塑特征

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Background: The purpose of this study was to evaluate the associations between patient characteristics or surgical site classifications and the histologic remodeling scores of synthetic meshes biopsied from their abdominal wall repair sites in the first attempt to generate a multivariable risk prediction model of non-constructive remodeling. Methods: Biopsies of the synthetic meshes were obtained from the abdominal wall repair sites of 51 patients during a subsequent abdominal re-exploration. Biopsies were stained with hematoxylin and eosin, and evaluated according to a semi-quantitative scoring system for remodeling characteristics (cell infiltration, cell types, extracellular matrix deposition, inflammation, fibrous encapsulation, and neovascularization) and a mean composite score (CR). Biopsies were also stained with Sirius Red and Fast Green, and analyzed to determine the collagen I:III ratio. Based on univariate analyses between subject clinical characteristics or surgical site classification and the histologic remodeling scores, cohort variables were selected for multivariable regression models using a threshold p value of ≤0.200. Results: The model selection process for the extracellular matrix score yielded two variables: subject age at time of mesh implantation, and mesh classification (c-statistic = 0.842). For CR score, the model selection process yielded two variables: subject age at time of mesh implantation and mesh classification (r2 = 0.464). The model selection process for the collagen III area yielded a model with two variables: subject body mass index at time of mesh explantation and pack-year history (r2 = 0.244). Conclusion: Host characteristics and surgical site assessments may predict degree of remodeling for synthetic meshes used to reinforce abdominal wall repair sites. These preliminary results constitute the first steps in generating a risk prediction model that predicts the patients and clinical circumstances for which non-constructive remodeling of an abdominal wall repair site with synthetic mesh reinforcement is most likely to occur.
机译：背景：本研究的目的是评估患者特征或手术部位分类与从腹壁修复部位活检的合成网片的组织学改建评分之间的关​​联，这是首次尝试生成非结构性改建的多变量风险预测模型。方法：在随后的腹部再探查期间，从51例患者的腹壁修复部位获得了合成网的活检。用苏木精和曙红对活检标本进行染色，并根据半定量评分系统评估其重塑特征（细胞浸润，细胞类型，细胞外基质沉积，炎症，纤维包囊和新血管形成）和平均综合评分（CR）。活组织检查也用Sirius Red和Fast Green染色，并进行分析以确定胶原蛋白I：III的比例。基于受试者临床特征或手术部位分类与组织学重塑评分之间的单变量分析，使用阈值p值≤0.200为多变量回归模型选择队列变量。结果：细胞外基质评分的模型选择过程产生两个变量：网格植入时的受试者年龄和网格分类（c统计量= 0.842）。对于CR评分，模型选择过程产生了两个变量：网格植入时的受试者年龄和网格分类（r2 = 0.464）。胶原蛋白III区域的模型选择过程产生了一个具有两个变量的模型：网状植入时的受试者体重指数和保龄年史（r2 = 0.244）。结论：宿主特征和手术部位评估可预测用于强化腹壁修复部位的合成网片的重塑程度。这些初步结果构成了生成风险预测模型的第一步，该模型预测了最有可能发生使用合成网片加固的腹壁修复部位非结构性重塑的患者和临床情况。

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