Tissue Healing in Overweight Patients During Allohernioplasty With Various Plastic Materials

Abstract

Excess body weight aggravates disease progression and negatively affects wound healing.
 The aim of the study is to the examine the features of tissue healing along the suture line of a postoperative wound in overweight patients with hernia repair with polypropylene material and titanium silk.
 Materials and Methods. Clinical laboratory examination was carried out in 44 overweight patients. Polypropylene mesh (n=23) or titanium silk endoprosthesis (n=21) were used for hernioplasty of inguinal or umbilical hernias. In the early postoperative period, the healing process was assessed in dynamics using cytological and instrumental methods.
 Results. It was established that after allohernioplasty in the early postoperative period, inflammation and microcirculation disturbances were recorded in the area of the wound tissues. In patients with polypropylene mesh, inflammation and microcirculation disturbances were more severe. Thus, the reparative processes in such patients were longer. Titanium silk endoprosthesis proved to be more effective. Its use in overweight patients did not disrupt reparative processes. However, in the early postoperative period, seroma was observed in the wound area in 5 patients with a polypropylene mesh (21.7 %) (χ2=4.176; р=0.041). In the long-term period, hernia recurrence was diagnosed in 4 patients (17.4 %) (χ2=3.394; p=0.066).
 Conclusion. Titanium silk in hernioplasty in overweight patients contributes to a better incomplete reparative tissue regeneration compared to polypropylene material. It also reduced wound complications both in the early and late postoperative periods.