EXPERIMENTAL REASONING ALLOPLASTY OF COMPLICATED HERNIA
Authors: Melnyk I. V. , Churpiy I. K. , Melnyk M. I. , Melnyk R. I. 
Published: July 2022

Hernia of abdominal wall found in 10% of the adult population and take 3-4 place in the structure of surgical diseases. Each year, on the planet performed over 20 million operations of hernia, which is 10-15% of all interventions. For plastic hernias of the abdominal wall during 1 year used 1 million synthetic fishing nets. In Ukraine, about 13 thousand operations performed on strangulated hernias of the abdominal wall when there is inflammatory exudate, infection in the wound.

Purpose. In the experiment to prove the applicability of polypropylene mesh for hernioplasty in cases of infection, phlegmon of hernia sac.

Materials and methods. The experimental research was conducted on 150 white male rats breed "Wistar" weighing 250-300 g, same age, without disease, detained in accordance with generally accepted standards, at least 10 days before the experiment. In carrying out the experiment followed the major domestic and international standards according to national "general ethical principles of animal experimentation" (Ukraine, 2001).

The open question of herniology is possibility of surgical treatment of hernia defect of abdominal wall at the hurt hernia, infecting of wound, phlegmon of hernia. For the study of problem, in an experiment on 150 white rats with the phlegmon of hernia complex research of features of flow of reparative process on an area the allogernioplastic polypropilene net of Linteks esfil is executed. The rats were divided into 3 groups: 1-st group – the plastic arts of hernia by the net of polypropylene of Linteks esfil standard; 2 group – the plastic arts by the net of Linteks esfil easy; 3 group – the plastic arts by the net of Linteks esfil heavy. The opened sore was washed by 0,02% solution of Decasan, Оctenisept farblos (Germany), intramuscular entered 1 ml of Imunophan, Ceftriaxon during a week. A positive dynamics was marked toward diminishing of contamination by microorganisms to 7 days after an operation. There were inflammatory changes in three groups: it was swollen hyperemia of tissues, serous-hemorrhagic excretions from a wound. On the 14th  days reticulated implant was densely fixed to the muscles and was in the thin layer of connecting fabric with more mature granulation fabric. In 21 day reticulated implant surrounded connective capsule which consisted of well-organized collagen fibres with the insignificant external signs of inflammation. 

The results of experimental researches confirm possibility of application of reticulated implant for the plastic arts of hernia defect in the phase of inflammation which more frequent meets at the hurt hernia. At presence of festerings excretions in hernia, the use of polypropilene net for the plastic arts must be accompanied careful rehabilitation of wound, abdominal region with adequate antibacterial therapy.

Conclusions:

The reaction of tissue to implant mesh matches with reaction of tissue bordering to necrotic cells, and the presence of an infected hernia does not worsen the conditions of integration polypropylene implant with tissues.

Strengthening mesh in tissues observed at 21 day, and the most pronounced effects of fixation - on 90 days after alloplastic hernioplasty of the hernia defect.

The results of experimental researches confirm the possibility of using plastic mesh implants for hernia defect in phase of inflammation that often occurs in strangulated hernia.