JPH0741063B2 - Chest wall mesh - Google Patents
Chest wall meshInfo
- Publication number
- JPH0741063B2 JPH0741063B2 JP61268902A JP26890286A JPH0741063B2 JP H0741063 B2 JPH0741063 B2 JP H0741063B2 JP 61268902 A JP61268902 A JP 61268902A JP 26890286 A JP26890286 A JP 26890286A JP H0741063 B2 JPH0741063 B2 JP H0741063B2
- Authority
- JP
- Japan
- Prior art keywords
- chest wall
- mesh
- months
- wall mesh
- chest
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
- 210000000779 thoracic wall Anatomy 0.000 title claims description 23
- 229920000954 Polyglycolide Polymers 0.000 claims description 8
- 239000004633 polyglycolic acid Substances 0.000 claims description 8
- 238000009940 knitting Methods 0.000 claims description 7
- 239000000463 material Substances 0.000 claims description 5
- 229920001577 copolymer Polymers 0.000 claims description 4
- 229920000642 polymer Polymers 0.000 claims description 4
- 229920000747 poly(lactic acid) Polymers 0.000 claims description 3
- 239000004626 polylactic acid Substances 0.000 claims description 3
- 239000004744 fabric Substances 0.000 claims description 2
- 210000001519 tissue Anatomy 0.000 description 8
- 238000006243 chemical reaction Methods 0.000 description 5
- 206010061218 Inflammation Diseases 0.000 description 4
- 238000000354 decomposition reaction Methods 0.000 description 4
- 238000011156 evaluation Methods 0.000 description 4
- 230000004054 inflammatory process Effects 0.000 description 4
- 229920001432 poly(L-lactide) Polymers 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 210000000038 chest Anatomy 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 210000000115 thoracic cavity Anatomy 0.000 description 3
- 241000282472 Canis lupus familiaris Species 0.000 description 2
- 241000283973 Oryctolagus cuniculus Species 0.000 description 2
- 239000004743 Polypropylene Substances 0.000 description 2
- 206010039203 Road traffic accident Diseases 0.000 description 2
- 230000007547 defect Effects 0.000 description 2
- 238000010438 heat treatment Methods 0.000 description 2
- 238000001727 in vivo Methods 0.000 description 2
- 230000009545 invasion Effects 0.000 description 2
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical compound CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 description 2
- 230000014759 maintenance of location Effects 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 208000018223 neoplasm of chest wall Diseases 0.000 description 2
- -1 polypropylene Polymers 0.000 description 2
- 229920001155 polypropylene Polymers 0.000 description 2
- 238000002271 resection Methods 0.000 description 2
- HSQFVBWFPBKHEB-UHFFFAOYSA-N 2,3,4-trichlorophenol Chemical compound OC1=CC=C(Cl)C(Cl)=C1Cl HSQFVBWFPBKHEB-UHFFFAOYSA-N 0.000 description 1
- 206010072960 Chest wall tumour Diseases 0.000 description 1
- 206010010356 Congenital anomaly Diseases 0.000 description 1
- 206010016717 Fistula Diseases 0.000 description 1
- 208000005422 Foreign-Body reaction Diseases 0.000 description 1
- 208000002325 Funnel Chest Diseases 0.000 description 1
- 206010019909 Hernia Diseases 0.000 description 1
- 229920000339 Marlex Polymers 0.000 description 1
- 241001465754 Metazoa Species 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 206010034203 Pectus Carinatum Diseases 0.000 description 1
- ISWSIDIOOBJBQZ-UHFFFAOYSA-N Phenol Chemical compound OC1=CC=CC=C1 ISWSIDIOOBJBQZ-UHFFFAOYSA-N 0.000 description 1
- 208000027790 Rib fracture Diseases 0.000 description 1
- 230000005856 abnormality Effects 0.000 description 1
- 230000033115 angiogenesis Effects 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 210000000845 cartilage Anatomy 0.000 description 1
- 238000002512 chemotherapy Methods 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 208000035475 disorder Diseases 0.000 description 1
- 230000003890 fistula Effects 0.000 description 1
- 230000008595 infiltration Effects 0.000 description 1
- 238000001764 infiltration Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 235000014655 lactic acid Nutrition 0.000 description 1
- 239000004310 lactic acid Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 238000006116 polymerization reaction Methods 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000001959 radiotherapy Methods 0.000 description 1
- 208000037922 refractory disease Diseases 0.000 description 1
- 239000012779 reinforcing material Substances 0.000 description 1
- 230000000241 respiratory effect Effects 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- 231100001061 sternum abnormality Toxicity 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 229920001059 synthetic polymer Polymers 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 238000009941 weaving Methods 0.000 description 1
Landscapes
- Materials For Medical Uses (AREA)
Description
【発明の詳細な説明】 （産業上の利用分野） 本発明は外科手術において胸壁の欠損修復のために使用
されるメッシュの提供に関する。Description: FIELD OF THE INVENTION The present invention relates to the provision of a mesh used for chest wall defect repair in surgery.
（従来技術） 現在、臨床で広く用いられている胸壁補修用の補強材は
ポリプロピレン製のMarlex Mesh（C.R.Bard,Inc社製，
商品名）がある。(Prior Art) Currently, a clinically widely used reinforcing material for chest wall repair is made of polypropylene Marlex Mesh (CRBard, Inc.,
There is a product name).
しかしながら、かかる従来のものは強度的には充分その
機能を果し得るが体内吸収性でないため生体組織が侵入
して胸壁を再建した後にも異物として体内に残り、少な
からず組織反応を起しつづける欠点を有する。また、成
長期の子供に適用したとき、胸壁再建後に胸壁の成長を
阻害することが知られている。However, such a conventional one can sufficiently perform its function in terms of strength, but it is not absorbable in the body, and thus remains in the body as a foreign body even after the invasion of the living tissue and rebuilding the chest wall, and a considerable amount of tissue reaction continues. It has drawbacks. It is also known to inhibit chest wall growth after chest wall reconstruction when applied to growing children.
（発明が解決しようとする問題点） 本発明はかかる点、生体内分解吸収性を特徴とする胸壁
メッシュを提供するもので、生体親和性に優れ、また、
機能を果したのち長く体内に残りつづけることがないた
め異物反応を起すことがなく、特に、成長期の子供への
適用において他に例をみない優れた効果を有するもので
ある。(Problems to be Solved by the Invention) The present invention provides a chest wall mesh characterized by biodegradability and absorbability in such a point, and is excellent in biocompatibility.
Since it does not remain in the body for a long time after performing its function, it does not cause a foreign body reaction, and has an excellent effect that is unprecedented especially when applied to growing children.
（問題を解決するための手段） しかるに、その構成において、生体吸収性の合成高分子
繊条により多孔状に編、織成されてなる生地をもって構
成されたことに特徴を有し、特に、その素材として生体
分解吸収性の高分子であるポリグリコール酸もしくはポ
リ乳酸もしくはこれらの共重合体で構成したことに特徴
を有するものである。(Means for Solving the Problem) However, in its constitution, it is characterized in that it is constituted by a fabric formed by knitting and weaving in a porous manner with a bioabsorbable synthetic polymer filament, and in particular, The material is characterized by being composed of polyglycolic acid or polylactic acid, which is a biodegradable and absorbable polymer, or a copolymer thereof.
（作用） 本発明メッシュが好適に適用される胸部外科領域におけ
る外科治療の例としては次のようなものがある。(Operation) The following are examples of surgical treatment in the thoracic surgery area to which the mesh of the present invention is preferably applied.
即ち、胸壁の異常として肋骨や胸骨の異常、漏斗胸、鳩
胸、胸壁ヘルニアなどで先天性のもの、或はこれらの後
天性のもの。また、交通事故や労務上での事故で胸壁に
重篤な損傷を起すもの。例えば、交通事故などの外傷で
同時に片側、あるいは両側胸郭の多数の肋骨骨折を生じ
胸郭のささえがなくなるため重篤な呼吸循環障害をきた
す動揺胸郭と呼ばれるもの。さらに胸壁の炎症や胸壁の
腫瘍。かかる炎症の場合は適切な化学療法を行えばよい
が難治のものは肋軟骨切除や瘻孔切除などを行う必要が
あり、また、腫瘍の場合も放射線療法を行うこともよい
が大部分の限局性胸壁腫瘍では外科的切除を行うことが
最もよい治療法とされ、これらのケースでは何れも外科
的な手術が必要とされている。That is, as chest wall abnormalities, ribs and sternum abnormalities, funnel chest, pigeon chest, chest wall hernia, etc., congenital or acquired. Also, it causes serious damage to the chest wall due to traffic accidents or labor accidents. For example, a swaying thorax that causes severe respiratory and circulatory disorders due to multiple rib fractures of one or both ribs at the same time due to trauma such as a traffic accident and the thorax is not supported. In addition, inflammation of the chest wall or tumor of the chest wall. Appropriate chemotherapy may be given in case of such inflammation, but costly refractory cartilage excision or fistula excision should be performed in case of refractory disease, and radiotherapy may be given in case of tumor, but most of them are localized. Surgical resection is the best treatment for chest wall tumors, and all of these cases require surgery.
かかる用途に適用されるメッシュは整形外科領域で用い
られる骨固定用器具ほどの高い力学的強度は必要とされ
ず、組織が入り込んで切除した胸壁が再建されるまで足
がかりとなるだけでも意味があり、従って、２〜３カ月
で分解吸収されるポリグリコール酸から18〜24カ月で分
解吸収されるポリ−Ｌ−乳酸まで所望の使い分けが可能
である。The mesh applied to such an application does not require as high mechanical strength as the bone fixation device used in the orthopedic region, and it is significant only to be a foothold until the excised chest wall is reconstructed due to the intrusion of tissue. Therefore, it is possible to selectively use polyglycolic acid which is decomposed and absorbed in 2-3 months to poly-L-lactic acid which is decomposed and absorbed in 18 to 24 months.
また、その適用は欠損部の大きさに合せて切断されたメ
ッシュを胸腔側から縫いつけて適用するものであり、か
かる素材は機能を果した後、徐々に体内に吸収され異物
として長く体内に留まることがなく、小児への適用にお
いても胸部の成長を妨げることがないため極めて理想的
である。In addition, its application is to sew a mesh cut according to the size of the defect part from the chest cavity side, and after such a material performs its function, it is gradually absorbed into the body and stays in the body as a foreign substance for a long time. It is extremely ideal because it does not hinder the growth of the chest even when applied to children.
以下、その構成及び適用効果等について例を挙げて説明
する。Hereinafter, the configuration, application effects, and the like will be described with examples.
［製造例１］ フェノール10に対しトリクロロフェノール７の割合で混
合した溶媒中にて溶解し、これを190℃で３分間加熱し
た後30℃まで冷却して測定したときの粘度（ηsp/c）が
1.5であるポリグリコール酸チップを245℃で溶融紡糸
し、延伸して６フィラメントで120デニールの糸を得
た。これを４本合糸してＳ撚を50T/Mかけた後、105℃に
て３時間熱処理した。この約480デニールのポリグリコ
ール酸糸を用いて14ゲージのトリコット編とし、編密度
266g/m2の胸壁用メッシュとした。[Production Example 1] Dissolved in a solvent mixed with trichlorophenol 7 in a ratio of 10 to phenol, heated at 190 ° C for 3 minutes and cooled to 30 ° C, and the viscosity was measured (ηsp / c). But
Polyglycolic acid chips of 1.5 were melt spun at 245 ° C and drawn to obtain 6 filaments of 120 denier yarn. Four of these yarns were combined, S twist was applied at 50 T / M, and then heat treatment was performed at 105 ° C. for 3 hours. Using this polyglycolic acid yarn of about 480 denier, we made a 14-gauge tricot knit, and knit density
A 266 g / m 2 chest wall mesh was used.
このようにして得た胸壁用メッシュは適度の腰を有し、
以下のように優れた評価を得た。The chest wall mesh thus obtained has an appropriate waist,
The excellent evaluation was obtained as follows.
［in vivo分解性評価］ 前記の如く構成したメッシュを1cm×5cmの大きさにカッ
トし、家兎の皮下に埋入し、１週、２週、２カ月後に屠
殺し、材料の分解吸収速度、組織反応をポリプロピレン
製の市販のマーレックスメッシュ（ソフト）との比較に
おいて評価した。[Evaluation of in vivo degradability] The mesh constructed as described above was cut into a size of 1 cm x 5 cm, and embedded subcutaneously in a rabbit, and sacrificed after 1 week, 2 weeks, and 2 months, and the decomposition rate of the material was absorbed. The tissue reaction was evaluated in comparison with a commercially available Merlex mesh (soft) made of polypropylene.
組織反応については２週間後マーレックツメッシュでは
毛細血管の侵入が見られたが、本例ではほとんどみられ
ず炎症反応の少ないことが認められた。２カ月後には本
例のメッシュは溶けてなくなっていた。Regarding the tissue reaction, after 2 weeks, invasion of capillaries was seen in the Marlek's mesh, but in this case it was hardly seen and it was confirmed that the inflammatory reaction was small. After 2 months, the mesh of this example had melted and disappeared.
また、強力保持率は第１表に示す通り初期及び術後に必
要とされるに十分な強力を保持し、その後分解により急
激に低下した。As shown in Table 1, the tenacity retention rate retained a sufficient tenacity required in the initial stage and the postoperative period, and then was rapidly lowered by decomposition.
これに対し、従来品は一定して低い強力を維持した。On the other hand, the conventional product maintained a constant low strength.
［実用評価］ 雑種成犬の右胸壁の肋骨を切断し、胸腔内側から前記に
より構成したメッシュを縫いつけた。 [Practical Evaluation] The ribs on the right chest wall of a mongrel dog were cut and the mesh constructed as described above was sewn from the inside of the chest cavity.
この縫合部の状態を見るため術後３週間、１カ月、２カ
月、２カ月目に実験犬を屠殺し、縫合部の状態を観察し
た。３週間目ですでに組織が入り込んで切除した胸壁が
再建されていた。１カ月後にはメッシュの目の形がまだ
見られるがメッシュそのものの強度はゼロに近い状態で
あった。In order to check the condition of the sutured part, the experimental dogs were sacrificed 3 weeks, 1 month, 2 months and 2 months after the operation, and the condition of the sutured part was observed. By the third week, the chest wall that had already been cut in due to tissue infiltration had been reconstructed. The mesh shape was still visible after one month, but the strength of the mesh itself was close to zero.
２カ月後には胸壁はほとんど完全に近い状態で再建され
ていた。尚、分解過程における周囲への組織反応は少な
く３カ月後には分解吸収されてメッシュの形は全くわか
らなくなっていた。Two months later, the chest wall had been nearly completely reconstructed. Incidentally, there was little tissue reaction to the surroundings in the decomposition process, and after 3 months, it was decomposed and absorbed, and the shape of the mesh was completely unknown.
［製造例２］ 分子量410000のポリ−Ｌ−乳酸チップを230℃で溶融紡
糸し、延伸して６フィラメント,120デニールの糸を得
た。これを４本合糸して50T/MのＳ撚をかけた後、105℃
にて３時間熱処理した。この約480デニールのポリ−Ｌ
−乳酸糸を用いて10ゲージのトリコット編とし、編密度
200g/m2の胸壁用メッシュを得た。[Production Example 2] Poly-L-lactic acid chips having a molecular weight of 410000 were melt-spun at 230 ° C and stretched to obtain a 6-filament, 120-denier yarn. This is combined with 4 yarns and S twist of 50T / M is applied, then 105 ℃
Was heat-treated for 3 hours. This 480 denier poly-L
− 10-gauge tricot knitting using lactic acid thread, knitting density
A chest wall mesh of 200 g / m 2 was obtained.
これを前記のin vivo分解性評価と同じように1cm×5cm
の大きさにカットし、家兎の皮下に埋入し、１カ月、６
カ月、12カ月、24カ月後に屠殺し、材料の分解吸収速
度、組織反応をみた。その結果、１カ月後に若干の血管
新生が見られたが以後は炎症反応も極めて少なく親和性
は良好であった。This is 1 cm × 5 cm as in the above in vivo degradability evaluation.
Cut into small pieces and embedded subcutaneously in rabbits for 1 month, 6
The animals were sacrificed after 12 months, 12 months and 24 months, and the decomposition rate of the material and the tissue reaction were observed. As a result, some angiogenesis was observed after 1 month, but thereafter the inflammatory reaction was extremely small and the affinity was good.
また、その強力保持率は１カ月、６カ月、12カ月後にお
いて夫々5.5Kgf,4.8Kgf,3.3Kgf,1.1Kgf,であり、24カ月
後においては０となり、体内に分解吸収されメッシュの
形は全くわからなくなっていた。In addition, their strong retention rates are 5.5Kgf, 4.8Kgf, 3.3Kgf, 1.1Kgf, respectively after 1 month, 6 months and 12 months, and become 0 after 24 months, and they are decomposed and absorbed in the body and the shape of the mesh becomes I didn't understand at all.
（発明の効果） 本発明は以上のように従来にない優れた特徴を有し、胸
壁切除部の補綴用として極めて好適に適用可能なもので
ある。(Effects of the Invention) The present invention has the above-described excellent features that have not been heretofore available and can be applied very suitably as a prosthesis for a chest wall resection site.
尚，例としてポリグリコール酸とポリ−Ｌ−乳酸を記述
したが、両者の共重合体によるメッシュも可能であり、
これらの組成や重合度、熱処理条件などにより分解性の
コントロールが可能なものである。Although polyglycolic acid and poly-L-lactic acid have been described as examples, a mesh made of a copolymer of both is also possible,
Degradability can be controlled by the composition, the degree of polymerization, the heat treatment conditions and the like.
また、その編織組織は特に限定はしないが、適用上密度
が200〜300g/m2の範囲にあるのが好適であり、これが20
0g/m2未満であると強力的に不足し、腰がないため適当
でなく、逆に300g/m2を越えると硬くなりすぎるため適
用したとき患部に刺激を与え好ましくない。また、その
編織組織は切断端のほつれなどが起らぬトリコット編が
特に好ましい。また、ポリグリコール酸とポリ−Ｌ−乳
酸或いは、両者の共重合体による交編織も勿論可能であ
る。The knitting structure is not particularly limited, but it is preferable that the density is 200 to 300 g / m 2 in application, and this is 20
When it is less than 0 g / m 2, it is not suitable because it lacks strength and lacks stiffness, and when it exceeds 300 g / m 2 , it becomes too hard and is irritating to the affected area when applied, which is not preferable. Further, the knitting structure is particularly preferably tricot knitting, which does not cause fray of the cut end. Further, it is of course possible to interwoven with polyglycolic acid and poly-L-lactic acid or a copolymer of both.
本発明は以上のように従来にない優れた胸壁用メッシュ
である。As described above, the present invention is an excellent chest wall mesh that has never been seen before.
───────────────────────────────────────────────────── フロントページの続き (72)発明者 西口 清 京都府綾部市青野町西馬場下38の１ グン ゼ株式会社研究所内 (72)発明者 山本 徹 京都府綾部市青野町西馬場下38の１ グン ゼ株式会社研究所内 審査官 鈴木 寛治 (56)参考文献 特開 昭61−181469（ＪＰ，Ａ) ─────────────────────────────────────────────────── ─── Continuation of front page (72) Kiyoshi Nishiguchi 38-1 Nishibaba, Aono-cho, Ayabe-shi, Kyoto Prefecture Gunze Co., Ltd. Research Institute (72) Toru Yamamoto 38, Nishibaba, Aono-cho, Ayabe-shi, Kyoto Prefecture 1 Gunze Co., Ltd. In-house Examiner Kanji Suzuki (56) References JP-A-61-181469 (JP, A)
Claims (3)
度を200〜300g/m2の範囲としたトリコット編地より成る
ことを特徴とする胸壁用メッシュ。1. A chest wall mesh comprising a biodegradable and absorbable polymer as a material, and a tricot knitted fabric having a knitting density in the range of 200 to 300 g / m 2 .
ル酸もしくはポリ乳酸であることを特徴とする特許請求
の範囲第１項記載の胸壁用メッシュ。2. The chest wall mesh according to claim 1, wherein the biodegradable and absorbable polymer is polyglycolic acid or polylactic acid.
ル酸とポリ乳酸の共重合体であることを特徴とする特許
請求の範囲第１項記載の胸壁用メッシュ。3. The chest wall mesh according to claim 1, wherein the biodegradable and absorbable polymer is a copolymer of polyglycolic acid and polylactic acid.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP61268902A JPH0741063B2 (en) | 1986-11-11 | 1986-11-11 | Chest wall mesh |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP61268902A JPH0741063B2 (en) | 1986-11-11 | 1986-11-11 | Chest wall mesh |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPS63122459A JPS63122459A (en) | 1988-05-26 |
| JPH0741063B2 true JPH0741063B2 (en) | 1995-05-10 |
Family
ID=17464855
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP61268902A Expired - Lifetime JPH0741063B2 (en) | 1986-11-11 | 1986-11-11 | Chest wall mesh |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPH0741063B2 (en) |
Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5294469A (en) * | 1992-06-17 | 1994-03-15 | Mitsui Toatsu Chemicals, Incorporated | Industrial woven fabric and composite sheet comprising same |
| CA2149900C (en) * | 1993-09-24 | 2003-06-24 | Yasuo Shikinami | Implant material |
| JP7691826B2 (en) * | 2021-02-18 | 2025-06-12 | グンゼ株式会社 | Tissue reinforcement material |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0611304B2 (en) * | 1985-02-07 | 1994-02-16 | グンゼ株式会社 | Rib cage support |
-
1986
- 1986-11-11 JP JP61268902A patent/JPH0741063B2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| JPS63122459A (en) | 1988-05-26 |
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