COMPARATIVE MORPHOMETRIC ASSESSMENT OF REGENERATION PROCESSES OF THE ANTERIOR ABDOMINAL WALL TISSUES AFTER IMPLANTATION OF VARIOUS TYPES OF POLYPROPYLENE MESHES IN THE EXPERIMENT

Abstract

The widespread introduction of modern alloplastic materials into the surgical practice has significantly improved the results of surgical treatment of patients with ventral and postoperative ventral hernia. However, the implantation of synthetic material in the tissue of the anterior abdominal wall is accompanied by different local reactions, especially when using "heavy" meshes, which often leads to the development of complications. Analysis of the results determines the relevance of this study.

The aim of the study – to conduct a morphometric assessment of changes in the arteries of the muscular aponeurotic layer after implantation of "heavy" and "light" polypropylene meshes and "light" in combination with a PRF membrane.

Materials and Methods. Morphometric analysis of the arteries of the musculo-aponeurotic layer after the implantation of "heavy", "light" polypropylene meshes and "light" in combination with the PRF membrane in a light-optical study of microscopic preparations. The experiments were performed on 18 mature male pigs of the Vietnamese breed, which were divided into 6 groups.

Results and its Discussion. The measurements in the group of intact animals showed that the outer diameter of the arteries of small caliber is (35.80±0.24) μm, the internal diameter is (12.60±0.15) μm, the thickness of the media is (10.50±0.09 ) μm, the Kernogan index (the ratio of the lumen area to the entire area of ​​the vessel) is equal to (12.40±0.12) %. The height of the endotheliocytes of these vessels reached (6.20±0.03) μm, the diameter of their nuclei – (2.98±0.02) μm. Nuclear-cytoplasmic relations in the studied cells were – (0.230±0.003). On the 28th day of the experiment under conditions of implantation of a light mesh, the thickness of the media vessels is equal to (10.90±0.12) μm. This morpho­metric parameter was 3.8 % higher than the same control and statistically significantly (p <0.05) control and was statis­tically significantly (p <0.05) different from it. During the implantation of the “light” mesh in combination with the PRF membrane, changes in the relative volume of damaged endothelial cells in the arteries of small caliber were noted. In the group 1 of observations, the indicated morphometric parameter is (2.40±0.03) %, and in the group 4 (2.60±0.09) %. Morphometric parameters of small-caliber arteries during the implantation of a “heavy” mesh showed an increase in the backward diameter of these vessels by only 0.22 %, and the internal diameter was almost unchanged and equal to (12.70±0.18) μm. The thickness of the media arteries of small caliber of the anterior abdominal wall was increased and reached (10.92±0.15) μm. The given morphometric parameter was statistically significantly (p <0.05) different from the similar control (10.50±0.09) μm. The revealed difference between the given morphometric parameters was equal to 4.0 %.

Conclusions. Morphometric measurements of small-caliber arteries established implantation of a “light” mesh compared to a “heavy” in the vitality period of the experiment led to pronounced re-modeling of the vessels under study, which was confirmed by relative volumes of damaged endothelial cells, which is (4.10±0.05) % and (4.90±0.05) %. The use of a light mesh with a PRF membrane for implantation resulted in the least pronounced structural reorganization of the arteries.