文档介绍：网片材料学网片材料学 Tension-free Hernia Repair : Mesh Prosthesis lPorous – tissue ingrowth lReactive – stimulate fibroblast ingrowth lInert – minimize foreign body reaction, allergic reaction, infection lStrength – to prevent early recurrence lFlexibility – avoid fragmentation lPorous – tissue ingrowth lReactive – stimulate fibroblast ingrowth lInert – minimize foreign body reaction, allergic reaction, infection lStrength – to prevent early recurrence lFlexibility – avoid fragmentation Ideal mesh characteristics Approach to Herniorraphy: lMetallic meshes - fragmentation problems lPolyethylene mesh – sterilization problems lPTFE – low porosity, minimal tissue ingrowth lPolypropylene – most widely accepted as the “ideal ” prosthetic material for extraperitoneal use. lMetallic meshes - fragmentation problems lPolyethylene mesh – sterilization problems lPTFE – low porosity, minimal tissue ingrowth lPolypropylene – most widely accepted as the “ideal ” prosthetic material for extraperitoneal use. Mesh characteristics Amid, ., Shulman, ., Lichtenstein, .,Selecting synthetic mesh for the repair of groin hernia Postgraduate General Surgery: 1992; Vol. 4, No. 2, pp 150-155 Tension-free Hernia Repair : Mesh Prosthesis Approach to Herniorraphy: 植入人体的理想生物材料的八点要求: ①在组织液中不引起物理变化, ②无化学活性, ③不存在炎症和异物反应, ④无致癌性, ⑤不产生过敏或致高敏, ⑥能耐受机械扭曲, ⑦能被随意剪裁, ⑧可消毒。曾作为疝修补材料被应用的有: ?金属材料细银丝、钽纱网、不锈钢丝、钴铬合金等?非金属材料福蒂森网(经拉伸和皂化的醋酯长丝)、聚乙烯纱布、尼龙、硅胶、矽状网、铁***龙、碳纤维、聚四***乙烯等?生物材料鼠、牛、鹿、鲸等动物的肌腱病人自身的筋膜、皮肤等常用的有 3种、后两种较能经受住考验并被广泛应用: 聚酯网片( 又称涤纶补片,Polyester Mesh, Dacron, Mersilene) , 聚丙烯网片( polypropylene Mesh , Marlex , PP)膨化聚四***乙烯网片( Expanded Polytetrafluoroethy- lene patch , e-PTFE )。可吸收网片有二种 Polyglycolic acid Poliglatin 910 用于战伤,感染伤口,肝,脾, 肾破裂修补等. 网片材料?可吸收材料–薇乔网片?不可吸收材料–聚丙烯网片–聚四***乙烯网片( ePTFE) –聚脂网片?复合材料–聚丙烯和聚四***乙烯复合–薇乔和聚丙烯复合–单乔和聚丙烯复合–植物性材料和高分子材料复合–动物胶原和高分子材料复合?生物材料–脱细胞细胞外基质目前使用的材料研发中的材料目前国内上市的网片 10家公司二十余种美国巴德公司 ( 单丝聚丙烯) 美国强生公司 ( 双丝聚丙烯) 德国贝朗公司 ( 单丝聚丙烯) 美国外科公