Morphological rationale for the application of titanium nickelide in reconstructive surgery of the diaphragm

Abstract

Purpose of the study: to experimentally study the morphological features of the reaction of diaphragm tissue to porous titanium nickelide in comparison with medical felt.Materials and methods. A series of experiments was carried out on 20 rats. The animals were divided into two comparison groups: in the main group (n = 10), the reaction of diaphragm tissue to an implant made of titanium nickelide was studied; in the control group (n = 10), an implant made of medical felt (fluoroplastic-4) was used. Animals were removed from the experiment 14, 30, 60 and 90 days after surgery. A histological study of the reaction of the diaphragm tissue to the implant was carried out, as well as the structural behavior of the material under study.Results. Macroscopically, after 14 days in the main group, a local adhesive process was noted. In the long term, the implant was covered with a thin connective tissue film without signs of inflammation. In the control group, after 14 days, phenomena of inflammatory infiltration with organ involvement were observed. After 30 days, the inflammatory infiltrate persisted with the formation of a connective tissue capsule. The implant increased in size with deformation, swelling, and in the long term, disintegration of the structure. Histologically, on the 14th day in both groups, granulation tissue formed between the implant and the diaphragm. By the 30th day in the main group, the number and thickness of collagen fibers increased, they filled the porous structure of the material. In the control group, the appearance of giant multinucleated cells was noted between the felt fibers, which are indicators of the body's tissue reaction to foreign material. On the 60th day in the main group, a regenerate of mature connective tissue formed around the implant, filling the pores of the material and spreading to the muscle fibers of the diaphragm. In the control group, a picture of productive granulomatous inflammation with phenomena of biodegradation of the material was observed.Conclusion. The results of the experiment demonstrated the absolute advantage of titanium nickelide in reconstructive surgery of the diaphragm. At the same time, the disadvantages of using medical felt associated with the body’s reaction to the material as a foreign body and the tendency to resorption are noted.