MORPHOLOGICAL FEATURES OF THE REPARATIVE PROCESS IN THE PLASTIC SECTION OF THE MUSCLE-APONEUROTIC DEFECT IN THE EXPERIMENT USING STEM CELLS

Abstract

Abstract. Anterior abdominal wall hernia repair is one of the most common procedures in general surgery. Very often, the parameters of the quality of life of operated patients with ventral hernias of the anterior abdominal wall during the fi rst year after the operation, according to a number of criteria, are signifi cantly better with alloplastic with polypropylene mesh, in contrast to the use of hernioplasty with the use of inert suture material. Hernias of the anterior abdominal wall (ventral hernias) most often occur after surgical intervention on the organs of the abdominal cavity and are considered postoperative complications arising in anatomically weak areas and under the infl uence of mechanical factors. The goal of the work. To experimentally investigate the eff ect of mesenchymal stem cells on the regeneration of muscle fi bers and their reparative properties in the area of postoperative wounds. When modeling a muscle- aponeurotic defect of the anterior abdominal wall with plasticity with own tissues and plasticity with an allograft in combination with injections of mesenchymal stem cells. The study was conducted on 38 white rats of both sexes, the initial weight of each animal was 215±12 g, the experimental animals were kept in the same conditions with full compliance with bioethical norms. All animals of groups 1 and 2 were experimentally modeled a muscle- aponeurotic defect of the anterior abdominal wall by an acute method up to 2.5 cm in diameter, followed by layer-by-layer suturing of this defect with a continuous wraparound single-row suture, «Vicryl» 3/0 with a barb was used as suture material with a needle In the 2nd group, plastic surgery was performed using the «on lay» technique with polypropylene mesh and suture material «Vicryl» 3/0 with a barbed needle, and mesenchymal stem cell injections were additionally performed. At the plastic site of the muscle- aponeurotic defect, the tissue of the anterior abdominal wall was taken in full layers for further histological examination. Histological examination of the wound tissues of animals of the control group 10 days after surgery showed that the wound defect was fi lled with granulation tissue at an early stage of maturation. After 30 days, the wound defect was fi lled with young loose connective tissue, in which there were sporadic islands of granulation tissue. In the area of the wound defect of 2 groups of experimental animals, after 10 days we detected maturing granulation tissue. Visually, the area of the lesion itself decreased. On the 30th day of the study, there was no granulation tissue, the wound defect was fi lled with fully matured newly formed and vascularized connective tissue. During the histological examination, it was found that as a result of the combined use of polypropylene mesh and stem cells, the regeneration of the wound defect is intensifi ed and its healing is accelerated.