The effectiveness of the reparative processes stimulation of the platelet-rich plasma in case of the abdominal wall endoprosthetics

Abstract

Relevance. The number of ventral hernias recurrence after abdominal wall endoprosthetics with the lightweight endoprosthesis is 8-10%.
 The purpose of the research is to study the morphological changes of the connective tissue, surrounding a lightweight polypropylene endoprosthesis, at the early stages of implantation at the use of platelet-rich autoplasma.
 Materials and methods. The results of experimental research of the course of wound process in the abdominal wall tissues during the implantation of the lightweight polypropylene prosthesis on 50 Chinchilla rabbits divided into 2 groups of 25 animal units each have been analyzed. Subaponeurotic implantation of the prosthesis was carried out in the first group of animals. In the second group, the platelet-rich autoplasma was twice introduced after the implantation of the prosthesis during surgery and on the third day of the postoperative period at the rate of 0,5 ml plasma per 1 cm2 of the endoprosthesis. The animals were taken away from the experiment on the 3rd, 7th, 10th, 14th and 21st day. Morphometric and histological study of reactive changes of tissue surrounding the implanted endoprosthesis was carried out.
 Results and its discussion. In the animals of the second group, the inflammatory response to prosthesis implantation was 1,3 times lower on the third day, 1,2 times lower on the 7th day, and 1,1 times lower on the 10th day, than in the first group. Fibroblastic response, on the contrary, has increased into 1,2 times on the third day, into 1,14 during the 7th day and into 1,18 during the 14th day after the introduction of autoplasma. The thickness of the connective tissue capsule in the second group was 1,57 times higher than in the first group on the 21st day of the experiment. At this time, in the first group, the immature connective tissue capsule has been represented by the loose collagen fibers and fibroblastic cells without separation into the layers. In the second group, a dense connective tissue frame has been formed by the mature collagen fibers arranged compactly and in parallel to each other. The layer-by-layer structure of the capsule is well expressed: the inner layer consists of the fibroblastic cells, and the outer layer consists of the mature collagen fibers.
 Conclusion. The use of platelet-rich plasma to stimulate reparative processes in the implantation of the lightweight polypropylene prosthesis in the abdominal wall is pathogenetically justified and effective.