The assortment and user qualities of biologically inert, synthetic, absorbable, and nonabsorbable thread has approached the limit of the requirements imposed by modern surgery. Further progress in this area can be anticipated if manufacturing processes for production of strong and elastic thread made of biocompatible absorbable natural polymers -polyoxyalkanoates (polyoxybutyrate, polyoxyvalerate and their copolymers), collagen, chitin, chitosan, alginate, etc., are developed. The attention of investigators is increasingly focusing on suture materials with both individual and comprehensive biological activity. Creation of thread containing native biological structures (cell growth factor, blood plasma proteins, cells of different organs and tissues, and other cells, including those that increase biocompatibility) and self-regulating materials with biologically active molecules in their structure capable of markedly altering their properties under small external physical or chemical effects, is promising.The basic functions of any surgical suture is to ensure relatively tight, hermetic, and reliable joining of sutured tissues and keep them in a fixed position with constant compression for all stages of wound healing, including postoperative edema. This predetermines special requirements for the strength and elasticity of suture materials and the ability to be reliably fixed with a surgical knot. Moreover, suture material must be biocompatible, pass atraumatically through tissues, have no capillarity and wicking, and retain its properties during sterilization and storage [1][2][3][4].After the wound margins have grown together, the function of the sutures is frequently exhausted and the foreign material must be removed from the body by operative removal of the sutures or preferably, as a result of biodegradation and absorption of the surgical sutures. However, in organ and tissue prosthetics in cardiovascular, plastic, and other areas of surgery, the sutures must guarantee reliable joining of synthetic prostheses and biological tissues for a very long time, i.e., bioresistant surgical thread is required. In many surgical situations, it is expedient to use antimicrobial and other biologically active sutures.The periodically discussed concept of creating a unified universal suture material for any surgical intervention is thus essentially groundless. Each concrete operation requires use of adequate suture material with consideration of the concrete situation -the patient's general condition and age, presence of infection, inflammatory processes, etc. For this reason, one problem that will determine the further progress of modern medicine is the creation of the most rational suture materials for surgery.It should be noted that the science school in the Department of Chemical Fibre Technology and the Problem Laboratory for Special-Application Fibres, created by the USSR scientists Professors A. I. Meos and L. A. Vol'f, made a serious contribution to the creation of domestic fibre materials for medical applications [5]...

Methods and manufacturing conditions were developed for giving ion-exchange properties to PCA fibres by graft polymerization of methacrylic acid to PCA fibres and styrene to PP fibres followed by sulfurization of the graft polystyrene. Antimicrobial surgical suture materials with fixation of antibiotics on the modified sutures by the ion-exchange mechanism were obtained. It was found that the duration and effectiveness of the antimicrobial action of the sutures are determined by the amount of antibiotic sorbed and the ionic bond strength of the latter with the ion-exchange groups in the sutures. The effect of the conditions of modification and methods of sterilization on the physicomechanical properties of the sutures was investigated. Antimicrobial surgical PCA sutures with the gentamycin Caprogent are recommended for use in general clinical practice and are being manufactured.One of the most effective methods of obtaining antimicrobial surgical suture materials is chemical modification of fibres with drugs [1]. Selection of this method predetermines a number of special requirements which must be considered in working with the initial materials and reagents.The fibres used must not only be biologically inert and sufficiently strong, but also contain active functional groups which can react with the drugs either directly or after additional modification [2]. In turn, the drugs must not be inactivated as a result of chemical addition itself or under the effect of the modification conditions. In consideration of these requirements, polycaproamide (PCA) and polypropylene (PP) fibres were used for production of antimicrobial suture materials.In view of the important losses (waste by oxidation) that take place in textile processing of fibres, chemical modification was conducted on finished textile articles. For this purpose, we made PCA and PP twisted surgical sutures with arbitrary numbers from 5/0 to 5 (metric size 1-7).To give the PCA and PP fibres antimicrobial activity, the drugs were attached to them by the ion-exchange mechanism. We developed methods for preliminary incorporation of cation-exchange groups in the fibres by grafting methacrylic acid (MAA) to the PCA fibres and styrene to PP fibres, followed by sulfonation of the graft polystyrene (PS).The reaction of grafting MAA to PCA fibre was initiated by peroxide and hydroperoxide groups obtained by mild oxidation with the Fe 3+ H 2 O 2 system. The advantages of this method are the important decrease in the probability of formation of homopolymer and preservation of the physicomechanical properties of the fibres.To incorporate peroxide and hydroperoxide groups in PCA, the fibre was successively treated with a solution of iron chloride in dilute hydrochloric acid and an aqueous solution of hydrogen peroxide. The oxidation process was monitored by the content of active oxygen in the PCA fibre.It was found that the acid medium causes swelling of PCA so that the number of peroxide and hydroperoxide groups, probably formed due to deeper penetration of the reagen...

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

Special technology has been developed for the production of polypropylene surgical monofilaments to meet medical needs for a suture material meeting tight specifications for physical and mechanical properties. To produce polypropylene monofilaments having improved elastic properties and strength, studies have been made on the effects of technological parameters (temperatures of liquid and of cooling bath, molding rate, thermal drawing ratios and temperatures, the thermal stabilization temperature, and temperature of additional thermal treatment of existing monofilaments with or without shrinkage) as regards the strength, elongation, the strength and elongation in knots, and bending rigidity. Conditions are given for making surgical monofilaments of various diameters with improved manipulation and strength.Polypropylene (PP) monofilaments are amongst the best nonresorbed suture materials, as they have high biocompatibility, good strength, resistance to biodegradation, lack of capillary performance, and reliable fixation of surgical knots. They have smooth surfaces and are monolithic, so they produce minimal damage on passing through tissues while providing a good cosmetic effect and reducing the painful sensations on removing the sutures. However, the characteristic rigidity means the risk of shearing of the tissues in the formation of wound swelling and difficulty in manipulation during operative intervention.The technical PP monofilaments produced by Russian industry cannot be used as surgical materials because of their low elasticity and consequently their low strength in knots, which usually does not exceed 50% of the strength of the monofilament. The strength in knots is a basic characteristic of a suture material, and it determines the reliability of the surgical procedure, so that parameter is to be found in the standardization documentation of EP and USP [1, 2].Medicine requires a material subject to tight specifications for the physicomechanical properties, so a special production technology is needed. The monofilament properties can be improved by physical modification, which is best combined with the making of the monofilaments.Monofilaments were made from isotactic polypropylene grade 21030; stabilization recipe 16 was used, which is permissible for medicine. The fluidity parameter for the liquid polymer was 2.5-4.0. The melt method was used to make the PP monofilaments, which was implemented with a continuous technological scheme on a plant made by the Italian firm of Covema.There are the following stages in making PP monofilaments: transporting and loading the polymer, melting the polymer, shaping (casting in a tank and preliminary drawing), thermal drawing, thermal stabilization, winding on a coil, and monitoring the physicomechanical properties, sorting, and packing. To improve the visualization of the filaments in a wound background, we added 0.2-0.3% of pigments permitted in medicine: phthalocyanin blue or green. In that case, the granulate before loading into the extruder bunker was treated with...

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