Abstract
The aim of the research is to determine morphological changes in the area of implantation of the polypropylene mesh implant and to determine the effect on the integration of the prosthesis of locally introduced adipose tissue and platelet rich plasma. Materials and methods. The experiment was performed on 36 sexually mature males of the Wistar line rats. The experiment simulated, studied and quantified local morphological responses and changes in developing in biological tissues that are in contact with implanted highly porous lightweight (80 g/m2) mesh implant in isolation and also in conditions of local administration of fatty graft and platelet rich plasma. Results: Assuming introduction of adipose tissue and platelet rich plasma in the zone of integration of mesh alloprosthesis under the influence of introduced regenerative cytokines as well as stromal stem cells activated by them there is an earlier activation of regenerative processes, enhanced angiogenesis which determines the optimal nature of the integration of the prosthesis with the formation of thin collagen fibers in more early terms minimizing excess peri-prosthetic fibrosis. Isolated introduction into the implantation zone of fatty suspension determines similar changes that have a slightly less pronounced character. These changes are quantitatively studied and the results obtained are statistically significant. Conclusions: Applying a fatty graft together with platelet rich plasma in the area of implantation of the lung polypropylene prosthesis, there was an accelerated tissue reaction from the integration of the prosthesis. Mesenchymal stem cells of adipose tissue that is a target for plasma cytokines enriched with thrombocytes have a more pronounced effect in stimulating reparative processes provided that they are simultaneously administered with PRP compared with isolated administration without PRP. The use of platelet rich plasma and adipose tissue design has a significant positive effect on local angiogenesis. Under conditions of improved angiogenesis and other stimulating factors in the conditions of introduction of adipose tissue and PRP, the integration of the prosthesis occurs with significantly lower peri-prosthetic fibrosis.
Highlights
IntroductionSurgical interventions for ventral postoperative hernias remain among the most common according to many authors [1, 2]
At the present stage, surgical interventions for ventral postoperative hernias remain among the most common according to many authors [1, 2]
System polypropylene implants have been widely used in hernioplastic operations due to significant biological inertia, high strength and sufficient elasticity [4], which allows the use of polypropylene mesh implants in alohernioplasty with good results [2, 5]
Summary
Surgical interventions for ventral postoperative hernias remain among the most common according to many authors [1, 2]. Operative introductions have become the gold standard of modern herniology, which in various variations adhere to the principles of non-aggressive plastics with the use of mesh prostheses [2, 3]. The integration of any materials in biological tissues develops non-specific inflammatory reactions by the type of “foreign body reaction” [3, 4] in the early alterative phase, resulting in excessive exudation. Such a mechanism explains the development of postoperative seromas in the zone of alohernioplasty. In the long-term period, the prolonged proliferative phase of inflammation determines excess peri-prosthetic fibrosis, which is realized in biomechanical complications, such as the sensation of an extraneous body in the plastic zone and local pathological impairment of mobility [5, 6]
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