Estudo comparativo entre o implante intraperitoneal de telas de polipropileno, polipropileno/poliglecaprone, poliéster/colágeno suíno e a sutura do plano musculoaponeurótico com poliglactina para reparo de defeito da parede abdominal de ratos

• Autor(a) principal: Ribeiro, Waston Gonçalves
• Data de Publicação: 2021
• Outros Autores: [e-mail]
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/19402
• topic: Surgical mesh; Tissue adhesions; Inflammation; Collagen; Foreign body reaction; Rats; Tela cirúrgica; Aderências teciduais; Inflamação; Colágeno; Reação tipo corpo estranho; Ratos; CIENCIAS DA SAUDE::MEDICINA::CIRURGIA::CIRURGIA EXPERIMENTAL

In this study, the intraperitoneal implantation of polypropylene mesh, tissue separating meshes based on polypropylene/poliglecaprone and polyester/porcine collagen was performed, compared to aponeurotic suture with polyglactin for repair an induced defect in the abdominal wall of rats (n=40). The study aimed to analyze the postoperative complications, compare the extension and intensity of adhesions formed between the intra-abdominal organs and the implanted meshes or the suture of the aponeurotic plane 21 days after the implant; evaluate inflammatory tissue response, foreign body reaction, fibroplasia and type I/III collagen ratio between aponeurotic polyglactin suture and intraperitoneal mesh implantation. Histological analysis was performed after staining with Hematoxylin-Eosin to assess inflammatory tissue response and foreign body reaction, in turn for fibroplasia assessment and collagen analysis staining using Picrosirius Red and computerized videomorphometry were used. Partial wound dehiscence was the most prevalent complication in all groups with a significant difference between the polyglactin suture group and the polypropylene/polyglecaprone mesh group, which had the highest number of complications (p-value=0.005). The polypropylene group showed greater impairment by visceral adhesions (p-value=0.001) and a greater degree of intense adhesions compared to tissue separating meshes (p-value<0.001). The polyester/porcine collagen group had more intense adhesions than the polypropylene/poliglecaprone group (p-value=0.035). The mesh groups had a higher inflammation score (p-value<0.05) and number of giant cells (p-value<0.05) compared to the polyglactin aponeurotic suture group, which had a higher tissue proportion of collagen type I/III in relation to tissue separating meshes (p-value<0.05). There were no significant differences between the mesh groups regarding tissue inflammation score, foreign body reaction, fibroplasia and collagen proportion. The intraperitoneal implantation of polypropylene meshes determined the appearance of extensive and firm adhesions with the intra-abdominal organs. The use of tissue separating meshes composed of polypropylene/ polyglecaprone or polyester/porcine collagen reduced the amount and degree of adhesions formed. The implant of the polypropylene/poliglecaprone mesh caused a greater number of postoperative complications in relation to the suture group with polyglactin of the aponeurosis. The intraperitoneal implantation of meshes, especially polypropylene/ polyglecaprone and polyester/porcine collagen meshes, determined a more intense and prolonged tissue inflammatory response compared to repair with polyglactin suture; as well as, it was associated with more immature, disorganized fibroplasia, marked by a reduction in the tissue proportion of collagen type I/III and a greater foreign body reaction, but without significant differences between the polypropylene group and the tissue separating mesh groups.