Objective To evaluate the outcome of pedicle graft of greater omentum and polypropylene mesh in reconstruction of large defect of abdominal wall caused by surgical incision. Methods From 1994 to 2004, 12 cases of large abdominal wall defects were repaired with pedicle graft of greater omentum and polypropylene mesh after removal of abdominal wall tumor; the defect sizes of abdominal wall ranged from 10 cm×7 cm to 25 cm×17 cm. Results The abdominal wall wound in 12 cases were healed by first intention. After a follow-up of 1 to 5 years, no complications of abdominal hernia, infection and intestine obstruction occurred in all patients. Conclusion It is reliable to repair abdominal wall defect caused by surgical incision with pedicle graft of greater omentum and polypropylene mesh instead of peritoneum.
Objective To study the biological activities ofthe nerve regeneration conditioned fluid (NRCF), especially to further separateand identify the protein bands of the relative molecular mass of (232-440)×103. Methods The silicone nerve regeneration chambers were implanted between the cut ends of the sciatic nerve in 6 New Zealand white rabbits (weight, 1.8-2.5 kg). The proteins in NRCF were separated by the native-polycrylamide gel electrophoresis (Native-PAGE), the protein bands of the relative molecular mass of (232-440)×103 were analyzed by the Shotgun technique, liquid chromatography, and mass spectrometry. Results The Native-PAGE result showed that there was 1 protein band of the relative molecular mass over 669×103, (232-440)×103 and (140-232)×103,respectively, and 6 bands of the relative molecular mass of (67-140)×103.Besides, 54 proteins were identified with at least 2 distinct peptides in 1 protein band of the relative molecular mass of (232-440)×103, including 4 unnamed protein products, mainly at the isoelectric points of 5.5-8.0 and of the relative molecular mass of (10-40)×103. Based on their functions in the protein database, allthe identified proteins in this study were classified into the following 5 groups: conjugated protein (43%), transport protein (30%), enzyme (6%), signal transducer (4%), and molecular function-unknown protein (17%). At the subcellular localization of the identified proteins, there was mainly a secreted protein (63%), and the remaining proteins were localized in the membrane and cytoplasm. Conclusion Native-PAGE and the Shotgun technique can effectively separate and identify proteins from NRCF, and can identify the components of the protein band of the relative molecular mass of (232-440)×103 and provide basicinformation on the unnamed protein products in NRCF.
The study aims to investigate the effect of the ratio of long axis to short axis (RLS) of upright polypropylene infusion bag on discharging process and to search the best RLS. Aiming at five different RLS (1.5:1, 2:1, 3:1, 4:1 and 5:1, respectively) with the volume of 100 mL, 250 mL and 500 mL, respectively, based on finite element method, analyzing the variation of stress distribution, emptying rate, drugging space and steadiness coefficient, etc. For the bags of the same volume, emptying rate increased with increasing of RLS, but the steadiness coefficient decreased with increasing of RLS. The specific increasing amplitude of emptying rate and decreasing range of steadiness coefficient were as follows: 20% and 49% for 100mL infusion bag, 9% and 51% for 250 mL infusion bag, and 11% and 46% for 500 mL infusion bag, respectibvely, when RLS increased from 1.5:1 to 5:1. Comparatively speaking, the increasing amplitude of the emptying rate is remarkably less than the decreasing range of the steadiness coefficient. By comprehensive consideration of both emptying rate and steadiness coefficient, lower RLS is recommended for upright polypropylene infusion bag.
OBJECTIVE: To investigate the effectiveness of polypropylene path (Prolene) in hernia prevention following harvesting of rectus abdominis is myocutaneous flap. METHODS: From November 1999 to October 2000, Prolene patches were applied in 26 cases to repair the anterior rectus sheath following harvesting free rectus abdominis myocutaneous flap. Data concerning each case included size of rectus flap, defect of rectus sheath, size of patch used, wound healing and complications. RESULTS: Prolene patch showed good biocompatibility with abdominal tissue. No foreign-body rejection occurred after operation. Seroma developed in 1 case, and was drained bedside without complication. All prolene patches healed well in the body during follow-up. Hernia formation and abdominal bulge were not observed. CONCLUSION: Prolene patch is a satisfactory material for repair of the anterior rectus sheath after harvesting free rectus abdominis myocutaneous flap.
目的 探讨应用人工合成材料双层聚丙烯补片修补腹壁切口疝的效果。方法 21例腹壁切口疝（15例大切口疝和及6例巨大切口疝）患者采用双层聚丙烯补片行无张力修补，对术中及术后情况进行分析。结果 全组病例手术顺利，手术时间 87～189 min，平均123 min。无严重并发症发生，痊愈出院。术后随访5～36个月（平均 17个月），无复发病例。结论 双层聚丙烯补片修补中下腹壁大切口疝及巨大切口疝是一种安全、有效的方法，是临床上治疗切口疝可供选择的一种手术方式。
Objective To compare the efficacy of retromuscular repair of incisional hernia by using ProGrip self-gripping mesh and conventional polypropylene mesh. Methods A retrospective analysis was made on clinical data of 83 cases of incisional hernia between May 2012 and May 2016. Of 83 cases, ProGrip self-gripping mesh was used in 46 cases (self-gripping mesh group) and conventional polypropylene mesh (conventional mesh group) in 37 cases. There was no significant difference in gender, age, body mass index, types of incision hernia, hernia ring diameter, course of disease, and associated disease between 2 groups (P>0.05). The operative time, hospital stays, and visual analogue scale (VAS) were recorded and compared between 2 groups. Results The self-gripping mesh group was significantly lower than conventional mesh group in operative time and hospital stays (t=2.977,P=0.004;t=2.270,P=0.026). Primary healing of incision was obtained in 2 groups, with no seroma and mesh infection. The VAS score of self-gripping mesh group was significantly lower than that of conventional mesh group at 24 hours, 7 days, and 30 days after operation (P<0.05). The follow-up time was 5-53 months (mean, 25.8 months) in 43 patients of self-gripping mesh group, and was 7-54 months (mean, 27.4 months) in 33 patients of conventional mesh group. No chronic pain or hernia recurrence was found in both groups during follow-up time. Conclusion It is a safe and feasible curative way to use ProGrip self-gripping mesh for retromuscular repair of incisional hernia as it can reduce operative time, hospital stays, and postoperative pain.
ObjectiveTo compare the outcomes after self-gripping mesh repair to ordinary polypropylene mesh secured with sutures in women’s Lichtenstein hernioplasty.MethodsThe clinical data of 116 female patients with primary unilateral inguinal hernia who were admitted to The First Affiliated Hospital of Zhengzhou University from January 2014 to January 2017 were prospectively analyzed. A randomized controlled trial was performed based on a random number table. All patients were allocated into self-gripping mesh group (PG group) and ordinary polypropylene mesh group (PL group). The outcomes included operative time, post-operative pain score, analgesic used, hospital stay, urinary retention, wound infection, and seroma were recorded. Patients were followed-up after 1 week, 1 months, 3 months, 1 year, and 2 years after operation. Follow-up data included chronic pain, foreign body feeling, affect daily activities, and recurrence.ResultsNinety-nine participants completed follow-up. There were 48 patients in the PG group and 51 participants in the PL group. The operative time of the PG group was significantly shorter than that of the PL group (P=0.045), but there was no significant difference in analgesic used, hospital stay, incidence of urinary retention and wound infection, visual analogue scale (VAS) of wound pain at rest at 1 week postoperatively, VAS of wound pain on coughing at 1 week postoperatively between the two groups (P>0.05). At 1 month after operation, the incidence of foreign body feeling in the PG group was significantly higher than that of the PL group (P=0.031), while there was no significant difference in ratio of VAS≥3 and incidence of affect daily activities (P>0.05). At 3 months, 1 year, and 2 years after operation, there was no significant difference in incidences of foreign body feeling, chronic pain, and affect daily activities between the two groups (P>0.05). There was one recurrence in the PL group and none in the PG group, without a significant difference (P=0.248).ConclusionThe surgical outcomes of self-gripping mesh are comparable to the ordinary polypropylene mesh with a reduced operation time in women’s Lichtenstein hernioplasty.
Objective To compare the effect of small intestinal submucosa(SIS)and polypropylene mesh(PPM) on repairing abdominal wall defects in rats, and toprobe into the feasibility of using SIS to repair the abdominal wall defects. Methods 100 SD rats(50 males and 50 females)were randomly divided into 2 groups(n=50). Their weight ranged from 200 to 250 g.Full thickness abdominal wall defects (2 cm×2 cm) were created by surgery and were repaired with SIS and PPM respectively. At different postoperative time (1st, 2nd, 4th, 8th and 12th week), animals were sacrificed to make histological observation. The tensile strengthand the development of adhesions were measured and observed. Results 95 animals survived and were healthy after surgery. No inflammatory response and obvious immunoreaction were observed in both groups. One week after operation, the tensile strengthof abdominal wall in SIS group (204.30±5.13 mmHg) was lower than that in PPMgroup(240.0±10.0 mmHg) at 1st week(P＜0.05),and there were no difference at 4th, 8th, 12th week. Adhesions were more marked in PPM group thanthat in SIS group(P＜0.05). Conclusion Both SIS and PPM are histologically compatible when used in rats and can maintain sufficient tensile strength. SIS is superior to PPM in regards to tissue compatibility and adhesion formation.
Objective To investigate the effectiveness of laparoscopic Y-shaped polypropylene mesh in the treatment of uterine and vaginal vault prolapse. Methods Between June 2010 and December 2012, 24 patients with uterine and vaginal vault prolapse were treated by laparoscopic pelvic reconstruction (vagina and uterus-sacral fixation) with Y-shaped polypropylene mesh. The age of patients was 35-60 years (mean, 48.6 years). The disease duration was 2-8 years (mean, 5 years). According to the pelvic organ prolapse quatitative (POP-Q) classification by International Continence Society (ICS), 16 cases were classified as uterine prolapsed degree II and 8 cases as degree III; 15 cases were classified as vaginal prolapse degree I, 7 cases as degree II, and 2 cases as degree III. All patients received postoperative follow-up regularly. Subjective evaluation was done based on prolapse quality of life questionnaire (P-QOL), and objective evaluation based on POP-Q classification. Results All the patients were operated successfully. The operation time was 22-68 minutes (mean, 33 minutes); the blood loss was 30-80 mL (mean, 51 mL); the indwelling urethral catheter remain was 3-7 days (mean, 4 days); and the hospitalization days were 4-9 days (mean, 6.8 days). Twenty-four patients were followed up 3-12 months (mean, 9 months), of whom, 2 were followed up less than 6 months. All patients had normal urination after withdrawal of urethral catheter, and the residual urine volume was in normal range. No patients had mesh erosion and discomfort during sex, vaginal and anal bearing down. The P-QOL scores at 3, 6, and 12 months after operation were significantly improved when compared with the preoperative value (P lt; 0.05); but there was no significant difference among 3, 6, and 12 months after operation (P gt; 0.05). The postoperative POP-Q classification was degree 0 in 19 cases and degree I in 3 cases, and the objective cure rate was 91.7%. No recurrence was found during follow-up. Conclusion Laparoscopic Y-shaped polypropylene mesh for treatment of uterine and vaginal vault prolapse is a safe and effective method, especially applicable to preserve the uterus, and higher requirements of sexual life of patients.