Experimental and morphological justification of the prevention of wound complications during fixation of the mesh to the abdominal wall tissues with composite

Abstract

The aim of the study is to justify the prevention of wound complications during fixation of the mesh to abdominal wall tissues with cross-linked polyurethane (CP) composite in experimental animals. Маterials and methods. An experimental study was conducted on 60 male laboratory rats, which were divided into 3 groups. In group I (n = 21), the mesh and wound edges were fixed with CP composite with an antiseptic, in group II (n = 24) – with ligatures, in group III (n = 15) muscle incision was performed and the wound was sutured with ligatures. The animals were observed for 30 days, wound healing and the presence of complications were evaluated. Morphological examination was performed on days 7 and 30. Signs of mesh germination by connective tissue and presence of tissue inflammation around the mesh were evaluated. Results. The observation results showed that in group I, the incidence of complications and the duration of wound healing were lower comparing to groups II and III. In group I, seroma was detected in 1 (5.3 %) animal, in group II – in 7 (33.3 %), in group III – in 3 (23.1 %), infection of the wound in 1 (5.3 %) animal of group I, in 4 (19.1 %) of group II and in 2 (15.4 %) of group III. The term of wound healing in group I was 7 (6; 8) days, in group II – 13 (12; 14), in group III –11 (10; 12) days (p < 0.05). The results of observation were confirmed morphologically, namely, in animals of group I, faster process of mesh germination with collagen fibers and wound healing were revealed, which was confirmed by the predominance of a fibrous component over the cellular one (р < 0.05), and the formation of a connective tissue capsule around the CP with the germination of collagen fibers deep into the capsule. Conclusions. The use of the cross-linked polyurethane composite with an antiseptic to fix the mesh implant to abdominal wall tissues in laboratory animals confirms its higher efficiency compared to traditional ligature fixation, by increasing the fibrous component of connective tissue and reducing the cellular component and hemodynamic disorders in dynamics, by the germination of collagen fibers deep into the capsule in the areas of mesh fixation, reduced occurrence of seroma and duration of wound healing, which justifies its use in clinical practice for prevention of wound complications in allogernioplasty.