LINEA ALBA COLLAGEN ASSESSMENT IN MORBIDLY OBESE PATIENTS.

João Vicente Machado Grossi,Martina Becker,Manoel Roberto Maciel Trindade,Eduardo Neubarth Trindade,Leandro Totti Cavazzola,Felipe Fernandes Nicola,Ivan Alberto Zepeda,Vinicius Von Diemen

doi:10.1590/0102-6720201600s10003

Abstract

ABSTRACTBackground:The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy. Aim: To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers. Methods:Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group). The samples were collected in 2013 and 2104, and were sorted according to age (18-30, 31-45 and 46-60), gender, BMI, waist and cervical circumference, and subcutaneous tissue thickness. Material for biopsy was collected from the supraumbilical region of the linea alba for immunohistochemical analysis differentiating collagen type 1 and type 3 and the 1/3 ratio. Image-Pro Plus pixel counting software was used to measure the amount of collagen. Results:The obesity group evidenced mean age 44.11±9.90 years; 18-30 age group had three (6.8%) obese individuals; 31-45 had 22 (50%) and 46-60 had 19 (43.1%). Females were present in 81.8% (n=36); BMI (kg/m²) was 48.81±6.5; waist circumference (cm) was 136.761±13.55; subcutaneous tissue thickness (cm) 4.873±0.916. Considering age groups, gender and BMI, there were statistical differences in all tests when compared with the cadavers. Conclusion:The amount of collagen in the linea alba above the umbilical region in the morbidly obese patients was smaller than in the non-obese cadavers in the same age group.

Highlights

The repair of abdominal wall hernias remains the most common operation for the general surgeon
To identify the factors that may influence the degree of strength and resistance of the abdominal wall in patients with high body mass index - above 35 kg/m2 - and possible postoperative hernia becomes critical to the surgeon[8]
This study aims to identify the predominant type of collagen in the anterior wall of patients undergoing bariatric surgery, comparing with non-obese cadavers

Summary

Introduction

The repair of abdominal wall hernias remains the most common operation for the general surgeon. The incidence of abdominal wall defects in obese patients is high, reaching 30% after laparotomy. To identify the factors that may influence the degree of strength and resistance of the abdominal wall in patients with high body mass index - above 35 kg/m2 - and possible postoperative hernia becomes critical to the surgeon[8]. The replacement of the structural matrix of the abdominal wall from type I collagen by type III has been described as a cause of hernias in the inguinal region[9,18]. This study aims to identify the predominant type of collagen in the anterior wall of patients undergoing bariatric surgery, comparing with non-obese cadavers

Objectives

Methods

Results