The Possible Ways of Adhesions Prophylaxis in Prosthetic Repair of Abdominal Wall (Experimental Study)


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Abstract

Relevance The treatment of patients with incisional hernias of abdominal wall is an actual question of surgery. The introduction of prosthetic repair improved outcomes of incisional hernia treatment and provided good life quality of operated patients. The unsolved problem is the prevention and treatment of complications associated with adhesions in the area of implantation of synthetic prosthesis. Are important works in which were studied the possibility of antiadhesive compositions based on hyaluronic acid.
The purpose of the study Is the study of possibilities of pharmacological compositions based on hyaluronic acid as a means of adhesions prevention in intraperitoneal prosthetic repair of abdominal wall.
Materials and methods In rabbits were implanted polypropylene (PP Std), light polypropylene (PP Light), polyvinylidenfluoride (PVDF) meshes by open IPOM technique. In basic group was used the composition based on hyaluronic acid. In control group the animals were operated without antiadhesive means. The implantation area was analyzed in 30 days.
Results and thier discussion In the control group, each of the implanted material developed an adhesive process. In some cases were observed strong adhesions. Ability endoprosthesis lead to the adhesions formation in the abdominal cavity was maximal in PP Std, medium in PP Light and minimum in PVDF series (non-significant). In the basic group adhesions were significantly low compared to the control. The observed differences were significant when comparing the groups and by comparing the results of implantation of each material separately. The most significant difference between the groups was observed in PP Std series. The most favorable results were noted in PVDF series of basic group.
Conclusion The antiadhesive impact of composition based on hyaluronic acid is confirmed in our experimental study. This effect dependent on the material of mesh. The morphological features of reparative process after prosthetic repair with use of composition based on hyaluronic acid should be studied.

About the authors

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Author for correspondence.
Email: admin@vestnik-surgery.com
MD, Prof., B.А. Korolyov Department of Hospital Surgery, Nizhnii Novgorod State Medical Academy

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Email: admin@vestnik-surgery.com
PhD, Surgeon, Nizhni Novgorod City Hospital No.35

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Email: admin@vestnik-surgery.com
Surgeon, Nizhnii Novgorod City Hospital No.35

Central Scientific Research Laboratory of Scientific Research Institute Applied and Fundamental Medicine, 70 Gagarin Ave., Nizhnii Novgorod, 603059, Russian Federation

Email: admin@vestnik-surgery.com
PhD, Assistant Prof., the Department of Humans and Animals Physiology and Biochemistry, the Nizhny Novgorod State University named after N.I.Lobachevsky, Research Worker, the Department of Neurophysiology and Experimental Simulation, Central Scientific Research Laboratory of Scientific Research Institute of Applied and Fundamental Medicine, Nizhnii Novgorod State Medical Academy

Nizhnii Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sqr., Nizhnii Novgorod, 603005, Russian Federation

Email: admin@vestnik-surgery.com
Urologist, Scientific Research Institute of Physical – Chemical Medicine, Federal Medical and Biological Agency, Moscow

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