SU869770A1 - Implant for perlacing tissues of abdominal wall - Google Patents

Description

(54) IMPLANT FOR THE SUBSTITUTION OF ABDOMINAL WALL TISSUES . An implant is known for replacing the tissues of the abdominal wall t containing fixing and separating elements made of synthetic nylon fibers. In this two-layer implant, the nylon mesh is used in combination with nylon tissue directly adjacent to the abdominal wall 1. In a living organism, a nylon implant quickly loses strength, which is associated with the high hydrophilicity of nylon. Tissue fluid, penetrating into the nylon fiber, expands the elements of its structure, which leads to the formation of longitudinal "transverse microcracks and subsequent elimination of the particles of the nylon fiber that makes up the implant. This may lead to a recurrence of the defect during the 1st, 2nd half after the operation due to the fact that the implant cannot prostrate to intraperitoneal pressure. A serious disadvantage of a double-layer implant is the use of nylon textile fabric as an element to be placed under the nylon mesh. Textile material, especially of thick woven fabric, does not grow well with connective tissue. The connective tissue forming the implant of the implant is inferior, mostly hyalinized. The process of formation of a connective tissue scar takes a long time, the newly formed connective tissue undergoes processes of fibrinoid swelling and fibrinoid cover, after which regenerative processes reappear. The aim of the invention is to reduce postoperative complications. The delivered ael is achieved by the fact that in the implachtat for substitution of fabrics 61 of the URINARY wall containing a fixing and separating element made of synthetic fibers, the fixing element consists of a mesh fabric, and the separating element is made of nonwoven material, and

made of polypropylene fibers. The fibrous canvas, the raw material for which is polypropylene fibers, is held together by needling of this canvas and the mesh weave of the smooth surface. The mesh of synthetic propylene weave threads serves as a frame for the nonwoven needle-punched cloth. It contributes to the additional fixing of the fibers in the structure of the fibrous canvas, as a raw material for the mesh fabric, polypropylene filaments with a linear density of 10 tex can be used. Physical and mechanical properties

The synthetic implant is sewn into the defect of the abdominal wall with single interrupted sutures conducted through all layers of the defect, except for the skin, with moderate tension, so that a part of the implant formed by the non-woven no-f polypropylene canvas contacts the abdominal organs. The skin under the implant is sutured tightly.

The physico-mechanical properties of the synthetic implant are presented in Tables 1 and 2. Table of synthetic implant

Elements of the proposed implant

Indicator Fibrous canvas, weight 50 g / m

Linear thread density, tex

0.45 gO, 55

Thickness, mm Weight, g / m; 50.0

Density on 50 mm vertically and horizontally

Bulk weight (density), g / cm

Permeability, l / cm min

Breaking load (N)

Explosive elongation,% Mesh fabric, weave smooth

10.0

l, 25fl, 75

0.8041.25 80.0g135.0 30.0t85.0

Р 115.0 + 180.0 Р 18.0 + 42.0

0.043-5-0.052

8.4

10.8

39,7t42,2 11,2g13,8 The proposed synthetic implant

58697706 Physical and mechanical properties of synthetic implant

Indicator

The length of the loop, mm

Clearance area mm

Breaking load (N) at

ball pushing,% (with

load 600 g)

Increase the surface when

punching with a ball,% Example 1. Sick M., 33 l was admitted to the hospital with complaints of pain in the left iliac region, worse when lying down, the presence of bulges in the right and left labia. She has been ill for 1 year, 4 years ago she was operated on for a hernia of the obturator hole on the left, a few days after the operation, hernial protrusions appeared in the area of the right and left labia majora. The general condition is satisfactory. In the area of the right labia majora there is a bulging elastic consistency, easily adjustable, 3x4x5 cm in size, appearing only when straining. In the area of the left labia majora, also during tugging, bulging is determined more than the posterior, up to 2 cm in diameter. The median laparotomy from the urinary process to the womb. The gallbladder is poorly emptied, contains stones; worm-shaped growth is chronically altered, in spikes. Cholecystectomy from laefl ki, appetidectomy was performed. The parietal peritoneum is dissected and detached from the pelvic dia. The peritoneal sac with internal organs is retracted upwards. Two synthetic polypropylene implants are stitched in the pelvic floor. The peritoneal bag is put in place. The integrity of the posterior leaflet of the parietal was restored; continuous continuous suture of the peritoneum, layer-by-layer sutures on the wound. The postoperative course is smooth. Recovery.

table 2

Mesh fabric, weave smooth. . Patient G., 50 years old, was admitted to the hospital with complaints of the presence of hernial protrusion in the upper abdomen. 2 years ago he was operated on for a strangulated hernia of the white line of the abdomen, the presence of which was not known. The postoperative course was complicated by suppuration of the wound; after two months, a hernia recurred. The general condition is satisfactory. In the upper abdomen, along the midline, there is a hernial protrusion, which is easily adjusted into the abdominal cavity. The dimensions of the hernia gate are 15x5 cm. Operation. Under the epidural anesthesia, a plastic anterior abdominal wall was carried out according to Napalkov, in the lower part of the wound the defect is closed with a synthetic polypropylene implant. Layered seams on the wound. The postoperative course was complicated by the formation of infiltrate in the postoperative wound area outside the implant zone. Recovery. The described implant ensures the replacement of abdominal wall defects, thus achieving prevention of postoperative complications by eliminating the formation of suppuration of the postoperative wound, formation of gray, the appearance of purulent fistulas, necrosis of the skin over the implant. The use of a bilayer implant will save lives and return the ability to work to patients with traumatic part of the abdominal wall, prevent dangerous and sometimes fatal complications, such as adhesive intestinal impassability. A synthetic implant is recommended for use during surgery for malignant and benign neoplasms of her, large, especially recurrent and postoperative, hernias, with the traumatic loss of a part of the abdominal wall.

Claims (1)

Invention Formula Implan; 7 atm for replacement of tissues of the abdominal wall containing fixing and separating elements made of synthetic fibers, characterized in that, in order to reduce postoperative complications, the fixing element consists of a mesh cloth, and the separating element is made of nonwoven material, and both are whole and made of polypropylene. fiber. Sources of information, accepted by iSo, attention during examination 1. Mushin A.Yu. Alloplasty abdominal wall defects. Author. on doc.diss. Riga, 1966.