Abstract:
Treatment of abdominal hernias remains one of the most urgent problems of modernsurgery. A large number of complications after hernia operations require the developmentof new types of implants for tissue plastic surgery. The purpose of the study is to carry outan experimental comparative assessment of tissue reaction to the implantation of thedeveloped polypropylene mesh implant modified with carbon nanotubes and silvernanoparticles. Research was conducted on 105 sexually mature laboratory rats in threeseries of experiments (35 rats each). In the first series, polypropylene mesh implantswere implanted in the tissues of the anterior abdominal wall, in the second - polypropyleneimplants coated with an antiseptic, and in the third - polypropylene implants modified withcarbon nanotubes and silver nanoparticles. Animals were removed from the experimentafter preliminary anesthesia 3, 5, 7, 14, 21, 30 and 90 days after the operation. Thetissues of the abdominal wall were taken together with the implants, histologicalpreparations were made, which were stained with hematoxylin and eosin and accordingto Van Gieson. We studied the composition and ratio of elements of cell infiltration intissues with further statistical processing of the obtained data. It was established thatduring the implantation of mesh edoprostheses, regardless of their type, necrotic changeswith reactive inflammation, the presence of inflammatory cell infiltrate, tissue swellingand microcirculation disorders were detected in the tissues 3-5 days after the operation.Under the condition of implantation of the developed mesh, a less pronounced exudativephase of inflammation and an earlier onset of the reparation phase were detected.Depending on the type of implant used, the subsequent reaction differed between thegroups of experimental animals, which was evidenced by the regression of inflammatoryphenomena in the tissues and the processes of formation of the fibrous capsule aroundthe implants. During the implantation of nanomodified mesh implants by the 7th day of theexperiment, the exudative phase of inflammation ended and the formation of a thinconnective tissue capsule began, the formation of which was completed by the 21st dayof observation, while when the mesh was implanted with polypropylene and polypropylenewith an antimicrobial coating, the formation of the capsule lasted up to 30 days. Thus, itwas established that the exudative phase of inflammation continues in the tissues aroundthe implantation of classic polypropylene and polypropylene meshes with an antimicrobialcoating up to the 14th day of the experiment, and the connective tissue capsule is formedup to the 30th day. At the same time, in the tissues around the mesh implants made ofpolypropylene modified with carbon nanotubes and silver nanoparticles, the exudativephase of inflammation ended by the 7th day of the experiment. This ensured the intensityof reparative regeneration processes and the separation of the implant from the surroundingtissues by a thin connective tissue capsule for up to 21 days of observation.
