Experimental use of a bioengineered heterograft in ventral hernioplasty in an infected wound

Background. Currently, the number of relapses after performed prosthetic hernioplasty techniques of the anterior abdominal wall, including those due to severe wound infection and rejection of the mesh prosthesis, reaches 5-10%. In this regard, the use of bioengineered transplants deprived of immune properties due to decellularization is a promising direction. The use of extracellular matrix promotes better engraftment of the material in the area of the hernial gate and, thereby, reduces the likelihood of wound complications in the postoperative period. However, in clinical practice, biological analogues of polypropylene mesh have low availability and high cost.

The aim of the study was to experimentally evaluate the local and general reaction of the body to the implantation of a bioengineered heterograft into a simulated defect of the anterior abdominal wall in an infected wound.

Materials and methods. The study was conducted on 90 male Wistar rats. The study objects were divided into three groups, comparable in number of observations (n=30 each) – the main group (onlay+bioengineered heterotransplant), the comparison group (onlay+polypropylene mesh, Lintex Esfil) and the control group (autoplasty). All animals were first formed a hernial defect along the white line of the abdomen, after which a staphylococcal suspension was injected into the wound to simulate an infected wound, and then the hernial defect was plasticized. In each group, the general and local reactions of the body to a particular material were evaluated on days 1, 5, 10, 30, and 180 after surgery.

Results. Based on an assessment of the local and general body response to various types of plastic surgery of a simulated hernial defect of the anterior abdominal wall of rats in an infected wound, it was found that a bioengineered heterograft promotes more effective wound healing (n=30-100%) compared with a polypropylene mesh (n=25 - 83.3%), which is confirmed by laboratory and objective data. with data.

Conclusion. The data obtained in the experiment allow us to consider the potential using bioengineered material in clinical practice, especially under increased risk of wound infection.