Experimental study of the collagen drug effect on the connective tissue structures formation in the area of the mesh implantation

B.S. Zaporozhchenko, I.G. Holodov, V.V. Kolodij, D.A. Bondarets, L.G. Rosha


Background. The problem of surgical treatment of ventral hernias remains relevant at the present time. The actual problem is choosing the best plastic material, meeting the requirements of an ideal prosthesis. Widely used polypropylene, due to reactions of implantation, causes formation of coarse connective tissue capsule, which deforms prosthesis. The question of minimizing the reaction of the body to the polypropylene implantation is not resolved, so finding ways to improve engraftment of polypropylene prosthesis continues. In this sense, the use of oral collagen is of high interest from the standpoint of studying the impact of animal collagen on the formation of complete connective tissue. However, the similarity of anterior abdominal wall structure in rats and humans allow for extrapolation of experimental data on humans. The aim of our work was to study the effect of using animal collagen on connective tissue formation in the area of the mesh prosthesis in experiments on rats. Materials and methods. Experimental studies were conducted on adult male Wistar white rats, in the preperitoneal layer of which a polypropylene mesh was implanted, with frame and without it; the animals were divided into 3 groups. The main and control group of animals were implanted a polypropylene mesh with frame. The main group received collagen preparation at a dose of 100 mg per 1 kg of body weight for 1.5 months, the control group did not receive collagen. Frameless mesh has been implanted in comparison group. In each group, sampling was performed after 15, 30 and 90 days. Polypropylene mesh was removed together with the surrounding tissues (subcutaneous tissue, fascia, muscle tissue, peritoneum) and investigated. Results. During the study of histological preparations in 15 days, we have found the initial formation of a thin connective tissue capsule around the mesh, where among a large number of cells of the inflammatory infiltrate and disseminated young fibroblasts and labrocytes, there was a number of newly formed blood vessels (capillaries). In the group with the use of collagen, a number of cells of inflammatory infiltrate was higher due to more expressive infiltration by lymphocytes and plasmocytes and a significant increase in the number of macrophags. In 3 months, the number of these cells in each group was the same. On day 30, the changes corresponded to the proliferative phase of wound healing. There was found a prevalence of fibrous matrix elements over the cell ones. In the study group, the number of elastic fibers was greater. Thin elastic fibers have a large number of branches, their number is increasing at the periphery of scar tissue, perivascularly and around collagen fibers; and in the study group, they are in all zones of the formed connective tissue, with a predominance on the periphery, their number is higher, there is a large number of branches and anastomoses. When staining by Van Gieson, we have revealed a dense connective tissue proliferation around the frame, and in the study group, newly formed fibers have equally low average thickness and agreed picture. In the other two groups, extremely thin fibers and broad stripes were observed, and the chaotic arrangement of the stripes predominated. When analyzing the vascularization of tissues around the mesh, in the main group of animals, starting from day 15, a significant increase (19.6 %) was noted in the average number of vessels in the focus of the experiment. In the future, this relationship remains. Obviously, the use of collagen stimulates the formation of new microvessels. Conclusions. Implantation of mesh cause transient inflammatory response expressed slightly, with the subsequent formation of a thin layer of connective tissue that can grow through the mesh, thus, combining it with the surrounding tissues. Mesh retains its softness and elasticity and doesn’t prevent normal wound healing process. The material is not absorbed, nor is destroyed and is no less strong under the influence of enzymes of surrounding tissues. Thus, our experimental study has allowed to document the following statement: collagen stimulates formation of new vessels, prevents ischemia of tissue in the area of allograft by increasing circulatory bed and keeps functioning a significant part of the newly formed vessels; the use of collagen optimizes the formation of a sufficient number of mature connective tissue in periimplant zone without deterioration of mechanical properties of allograft; the use of collagen can increase the biological compatibility and improve engraftment of mesh implants.


hernias; collagen; stimulation of collagen genesis


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