RESULTS OF THE EXPERIMENTAL SUBSTANTI ATION OF AN IMPROVED METHOD FOR THE TREATMENT OF VENTRAL HERNIAS
Keywords:
ventral hernia, alloprosthetics, hernia orifice plasty, experimental modelAbstract
To date, despite the achievement of certain successes in the treatment of hernias, many issues of herniology remain unresolved and controversial. Therefore, the development and introduction into surgical practice of more effective methods of hernia treatment aimed at determining the gradations of histocompatibility of the tissues of the anterior abdominal wall with various synthetic materials, as well as a differentiated approach to the choice of allomaterial, determine the relevance of this problem and its important social significance. The purpose of the study was to evaluate the results of histocompatibility of alloprostheses using several types of prosthetic materials on an experimental model of external abdominal hernias. Experimental studies were carried out in the TMA vivarium on New Zealand White rabbits with an average weight of 5 kg (4600-5400 grams) in strict compliance with the requirements of the European Convention for the Protection of Vertebrate Animals used for experimental and other scientific purposes. Experimental animals were made 4 transverse sections 3 cm long on both sides of the midline. After preparing the site for alloplasty, each experimental animal was implanted with various alloplasties (thin porous polypropylene, large porous polypropylene, ultrapro, acrylic) with dimensions of 3.0x1.0 cm. On the 10th and 45th days, the material was taken and morphological studies were performed to assess the degree implant adhesion. Thus, we improved the experimental model of external abdominal hernias, which consisted in the fact that several types of allomaterials were implanted on one experimental animal in equivalent areas of the anterior abdominal wall, which made it possible to achieve identical conditions for the healing of various allomaterials. Taking into account the different physicochemical properties of the meshes, we conducted experimental studies on the healing of various allografts.
References
Figure 2. Microscopic image of tissues after application of 4 types of allomaterials Day 45 (approx. 10. et al. 20.): a) Ultrapro. mesh fibers. Hematok. old eosin. color; b) Acrylic. Swelling and homogenization of mesh fibers. Hematok. and eosin; c) large-pore polypropylene. Vascular reaction, thickening of interstitial collagen. Hematok. old eosin. color; d) finely porous polypropylene. Increased lymphoid infiltration. Hematok. eosin. color.
The conducted morphological studies showed that in acrylic, ultraporous, large-porous polypropylene types, regenerative processes proceeded relatively evenly, in combination with free penetration of fibroblasts and subsequent growth of collagen fibers both around nodal joints and around single-layer implants, with less cicatricial changes close to physiological . When using a large pore mesh, large pores caused more natural fibroblastic infiltration. Acrylic and ultrapro have the best repair rates, since some fibers are hydrolyzed, making room for the connective tissue growing in them, while the percentage of a foreign body remaining in the body and the reaction to it are also minimized.
When using especially finely porous polypropylene, a more pronounced inflammatory and fibroblast reaction was observed with the formation of dense, hypertrophied connective fibers. This is due to an excess of insoluble synthetic material that stimulates the proliferation of fibroblasts, a disproportionate growth of regenerating tissues for the species, a more pronounced inflammatory reaction that activates collagenization.
Conclusion: Thus, we improved the experimental model of external abdominal hernias, which consisted in the fact that several types of allomaterials were implanted on one experimental animal in equivalent areas of the anterior abdominal wall, which made it possible to achieve identical conditions for the healing of various allomaterials. Considering the different physicochemical properties of the meshes, we carried out experimental studies on the healing of various allografts.
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