Year 2016 Vol. 24 No 4

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

V.V. KUDLA 1, I.G. ZHUK 2, R.I. KRAVCHUK 1, M.A. KURBAT 1, R.R. ZHMAILIK 3

ULTRAMICROSCOPIC COMPARATIVE EVALUATION OF THE LIVER TISSUE REACTION TO THE CLOSURE OF ITS WOUND SURFACE BY THE OMENTUM AND FLUOROPLASTIC

EE "Grodno State Medical University"1,
Grodno Regional Council of Deputies2,
ME "City Clinical Emergency Hospital"3
Grodno
The Republic of Belarus

Objectives. To carry out a comparative evaluation of the liver tissue reaction at the ultrastructural level to closure of its wound surface by the omentum and fluoroplastic.
Methods. In the experiment on white rats the marginal resection of the left liver lobe was performed. In the 1st group the wound was peritonized by the strand on the vascular pedicle of omentum fixed to the capsule with koralen 7/0 single interrupted sutures. In the 2nd group the wound defect was closed by a fibrous-porous fluoroplastic flap (2 mm thickness). On the 21st day 5 animals from each group were withdrawn from the experiment. At a distance of 5 mm in depth from the wound surface the samples of material were taken to produce the electron-microscopic preparations. The complex of digital camera Olympus Mega View III and the program for image processing iTEM were used. The morphometric evaluation of quantitative and qualitative parameters of hepatocyte mitochondria with further statistical analysis of the obtained material was performed.
Results. It has been found out that in closure of the liver wound by the omentum and fluoroplastic the similar reversible changes including activation of reparative processes in response to injury after surgery are developed at the ultrastructural level. However, the use of polymer fluoroplastic for plastic closure also causes increased secretory processes with moderate cellular response of the mononuclear phagocyte system. In addition, in the second group the number of lipid inclusions in hepatocytes being an additional source of energy production is increased. At the same time, the signs of active collagen production and therefore fibrosis at the subcellular level are not determined.
Conclusion. The use of the fluoroplastic for the plastic closure of the liver wounds in the experiment is justified due to evoking the same ultrastructural changes in the liver tissue so as using the greater omentum for this purpose.

Keywords: liver wound, resection, omentum, fluoroplastic, peritonization, lipid inclusions in hepatocytes, sealing
p. 328-335 of the original issue
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Address for correspondence:
230025, Republic of Belarus, Grodno, Sverdlov st, 3,
EE "Grodno State Medical University", chair of operative surgery and topographic anatomy.
Tel: + 375 152 72-11-72 E-mail: kudloviktor@gmail.com
Kudla Viktor Valentinovich
Information about the authors:
Kudla V.V. Senior lecturer, EE "Grodno State Medical University", chair of operative surgery and topographic anatomy.
Zhuk I.G. MD, Professor, Chairman, Grodno Regional Council of Deputies.
Kravchuk R.I. PhD (B), Senior researcher, "Grodno State Medical University", research department.
Kurbat M.A. PhD, Ass. Professor, Head, EE "Grodno State Medical University", research department.
Zhmailik R.R. Surgeon-intern, ME "Grodno Clinical Emergency Hospital".
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