1 Кафедра общей хирургии, 2 кафедра оперативной хирургии и топографической анатомии, 3 кафедра гистологии, эмбриологии, цитологии Курского государственного медицинского университета, Курск;4 Общество с ограниченной ответственностью «Линтекс», Санкт-Петербург E-mail: SukovatykhBS@kursksmu.netПредставлены результаты экспериментального исследования на кроликах породы шиншилла легкого усиленного эндопротеза при над-и подапоневротической имплантации в ткани брюшной стенки. Проведено морфологическое исследование образцов брюшной стенки с имплантированным материалом. Исследовали площадь клеточного ин-фильтрата, располагающегося непосредственно вокруг нитей эндопротеза в клеточном слое капсулы, и площадь вновь сформированной соединительнотканной капсулы, вычисляли клеточный индекс, представляющий собой отношение клеток гистиоцитарного ряда к клеткам воспалительного инфильтрата. В результате проведенного исследования уста-новлено, что на ранних сроках более быстрое купирование воспалительных изменений и образование соединительно-тканной капсулы отмечается вокруг эндопротеза при подапоневротической имплантации, а на поздних сроках течение репаративной реакции не зависит от варианта расположения протеза.Ключевые слова: грыжа живота, легкий усиленный эндопротез, герниопластика, площадь клеточного инфиль-трата, площадь соединительнотканной капсулы, клеточный индекс, полипропиленовый эндопротез. Limited Liability Company "Lintex", St. Petersburg The article presents the results of experimental study of the light strengthened endoprosthesis on rabbits of chinchilla specie at onlay and sublay implantation in the abdominal wall tissues. There was done morphological study of abdominal tissue samples with implanted material. The area of cellular infiltrate located around the threads of endoprosthesis in cellular layer of the capsule, and area of newly formed connective tissue capsule were investigated. Cellular index was calculated as the ratio of the histiocytic cells to the inflammatory infiltrate cells. In the result of the study authors prove that at early periods the more rapid stopping of inflammatory changes and formation of the connective tissue capsule take place around endoprosthesis at sublay implanting, while at later periods reparative response does not depend on arrangement option of prosthesis. PECULIARITIES OF ABDOMINAL WALL TISSUE RESPONSE ON IMPLANTATION OF THE LIGHT STRENGTHENED ENDOPROSTHESIS FOR HERNIOPLASTY IN RELATION TO ITS ARRANGEMENT OPTION

The OBJECTIVE was to evaluate the effectiveness of the method developed in the clinic for the treatment of umbilical hernias with simultaneous lifting of the abdominal wall and the urogenital perineum in women. MATERIAL AND METHODS. The treatment of 40 patients suffering from umbilical hernias, abdominal ptosis and stress urinary incontinence was analyzed. The patients were divided into 2 groups of 20 people. In the first group, treatment was carried out by supaponeurotic endoprosthesis replacement of the umbilical ring of the abdominal wall, and in the second group – with simultaneous lifting of the abdominal wall and the urogenital perineum. RESULTS. Integral indicators of the quality of life of patients in the second group were 1.3 times higher than in patients in the first group by physical component, and 1.2 times – by psychological component. CONCLUSION. The original technique was effective and pathogenetically supported.

Importance of the topic. One of the directions of improving hernioplasty efficiency with the use of light synthetic materials is including the strengthening zones in their structure. Purpose. To compare functional effectiveness of the light and the light strengthened polypropylene endoprostheses for hernioplasty on the base of studying biomechanical characteristics of anterior abdominal wall tissues after their implantation in experiment. Materials and methods. Experimental studies were conducted on 36 rabbits of “chinchilla”  breed. All animals were divided into 2 series of experiments. In the first (control) series the light polypropylene endoprosthesis was implanted, while in the second (experimental) series there was used a new cancellated  endoprosthesis from monofilamentous polypropylene, consisting of the basic and strengthened zones in the form of horizontally located, alternating with each other monothreads of the higher thickness. Pathomorphological changes and biomechanical properties of the abdominal wall tissues were studied macroscopically in the experiment by implantation of endoprostheses in onlay position on the 7th, 30th and 90th  days. Results and their discussion. There was proved that in direction of the loop column as well as in the  loop row after implantation of the studied materials breaking load increased from the 7th to the 90th day of experiment, that was related to the formation of the connective tissue capsule around materials. The light strengthened endoprosthesis was more durable and stronger in 1,6 times compare to the light analog at all stages of observation. Along the loop column there was no significant difference detected. In both series of experiment in the direction of the loop column as well as in  loop row the reduction of sample lengthening took place. Along the loop column indicators of lengthening, characterizing elasticity of the prosthesis aponeurosis, in the series of the light strengthened endoprosthesis were 1,4-1,6 times lower than in its light analog. Along the loop row there was no significant difference of indicators. Conclusion. Introduction of the strengthened zones in a light endoprosthesis increases its durability with preservation of the material’s elasticity.