Title | ANALIZA REAKTIVNOSTI RESORBIRAJUĆIH, NERESORBIRAJUĆIH I BIOLOŠKIH UGRADBENIH MATERIJALA U KIRURGIJI HERNIJE NA MODELU ŠTAKORA |
Author | Jakša Filipović Čugura |
Mentor(s) | August Mijić
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Abstract | Ova studija je učinjena da bi se analizirao smjer razvoja mrežica od neresorptivnih do bioloških mrežica. Niti jedan do danas korišteni materijal ne zadovoljava sve navedene uvjete, no prepoznata su neka mjesta ugradnje i stanja organizma u kojima jedna vrsta materijala ima prednost nad drugom. Tako se pri direktnom kontaktu mrežice s visceralnim organima koriste resorptivne mrežice, a za ugradnju u kontaminirana ili potencijalno kontaminirana područja preporučuju se biološki materijali. Iako je još uvijek najčešće korišten materijal u kirurgiji hernije polipropilen i prošireni politetraflouretil (e-PTFE), predviđa se kako bi u bliskoj budućnosti biološki materijali mogli imati vrlo veliku ulogu u reparacijama velikih defekata abdominalne stijenke i u dijafragmalnim hernijama.
Cilj istraživanja bio je usporediti tri vrste ugradbenih materijala koji se koriste u modernoj kirurgiji hernije – neresorbirajuće materijale (predstavljene mrežicom TiMesh proizvođača GfE), resorbirajuće materijale (predstavljene kroz mrežicu Vypro II proizvođača Ethicon) i biološke (mrežica Surgisis proizvođača Cook Surgical).
U studiji su prikazani rezultati sumarno i pregledno razmotreni s aspekta promatranih parametara (upala, vaskularizacija, fibroza, odlaganje kolagena, stanična proliferacija i formiranje granuloma) te su donijeti zaključci nastali i od promatranih aspekata interakcije ugrađene mrežice i domaćina. Parametri su razmotreni na način kako bi se rezultati objasnili logički, u smislu slijeda događaja kojima je karakterizirana interakcija organizma domaćina, ugrađenog materijala i posljedica kirurškog zahvata. U ovoj studiji se pokazuje prednost biomaterijala naspram ostalih dviju mrežica u vidu načina stvaranja povoljnog okvira za cijeljenje rane i inkorporaciju ugrađenog materijala, pravilnije odlaganje kolagena, veći intenzitet proliferacije fibroblasta i neovaskularizacije, slabije izražene reakcije stranog tijela i na potvrđenu prednost u inficiranom mediju biomaterijala. |
Keywords | hernia non-resorptive mesh resorptive mesh biological mesh vascularization cell proliferation |
Parallel title (English) | REACTIVITY ANALYSIS OF RESORPTIVE, NON-RESORPTIVE AND BIOLOGICAL EMBEDDING MATERIAL IN HERNIA SURGERY ON THE EXAMPLE OF RATS |
Committee Members | Mario Ledinsky (committee chairperson) Hrvoje Čupić (committee member) Mario Zovak (committee member) Leonard Patrlj (committee member) Aljoša Matejčić (committee member)
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Granter | University of Zagreb School of Dental Medicine |
Lower level organizational units | Chair of Internal Medicine |
Place | Zagreb |
State | Croatia |
Scientific field, discipline, subdiscipline | BIOMEDICINE AND HEALTHCARE Dental Medicine
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UDK | 616.31 APPLIED SCIENCES. MEDICINE. TECHNOLOGY Stomatology |
Study programme type | university |
Study level | postgraduate |
Study programme | dental medicine |
Academic title abbreviation | dr.sc. |
Genre | doctoral thesis |
Language | Croatian |
Defense date | 2015-02-08 |
Parallel abstract (English) | This study was performed to analyze the direction of mesh development, from non-resorptive to biological mesh. None of the materials used today meet all these requirements, but some embedding locations and body condition in which one type of material has an advantage over the other have been recognized. Thus, in case of a direct contact of the mesh with visceral organs, resorptive mesh is used, whereas for installation in contaminated or potentially contaminated areas, biological materials are recommended. Although polypropylene and expanded polytetrafluoroethylene (e-PTFE) remain the most commonly used materials in surgery, it is anticipated that in the near future biological materials could have a major role in repairing large defects of the abdominal wall and diaphragmatic hernia. The aim of the study was to compare three types of embedding materials used in modern hernia surgery - non-resorptive materials (presented with TiMesh manufactured by GfE), resorptive materials (presented with Vypro II mesh manufactured by Ethicon) and biological (Surgisis mesh manufactured by Cook Surgical). The study presents the results summarized and clearly discussed in terms of observed parameters (inflammation, vascularization, fibrosis, collagen deposition, cell proliferation and granuloma formation) and makes conclusions on the basis of the observed aspects of the interaction between the embedded mesh and host. The parameters are discussed in a way to explain the results logically, in terms of sequence of events, which is characterized by the interaction of the host organism, embedded material and the result of a surgical procedure. This study shows the advantage of biomaterials over the other two types of mesh in terms of the way of creating a favourable framework for wound healing and incorporation of the embedded material, more regular collagen deposition, greater intensity of fibroblast proliferation and neovascularization, less visible foreign body reaction, as well as the confirmed advantage in the infected medium of biomaterials. |
Parallel keywords (Croatian) | hernija biomaterijali neresorbirajuće mrežice resorbirajuće mrežice biološke mrežice vaskularizacija stanična proliferacija |
Version | accepted version |
Resource type | text |
Access condition | Open access |
Terms of use |  |
Note | accepted version |
URN:NBN | https://urn.nsk.hr/urn:nbn:hr:127:249523 |
Committer | Vesna Borić |