Year 2014 Vol. 22 No 5

GENERAL AND SPECIAL SURGERY

I.S. IVANOV, V.A. LAZARENKO, S.V. IVANOV, G.M. SUKHOV, A.V. TCUKANOV, G.N. GORYANOVA, E.G. OBEDKOV, G.N. GAFAROV

DISORDERS OF THE CONNECTIVE TISSUE STRUCTURE COMPOSITION OF THE ANTERIOR ABDOMINAL WALL IN PATIENTS WITH VENTRAL HERNIA

SBEE HPE Kursk State Medical University,
The Russian Federation

Objectives. To find out the differences in the structure of collagen fibers in the skin and aponeurosis in patients with ventral hernias and without them.
Methods. 46 patients suffering from the anterior abdominal wall hernias composed the main group, 49 patients without signs of hernia disease or the signs of connective tissue dysplasia made up the control group.
The specimens of the skin and aponeurosis were taken during the planned surgical operations. The specimens were stained with Sirius Red dye and investigated by use of a polarization microscope Altami Polar 2, at magnification ×250 and ×400. Architectonics of the skin and fascia were studied as well as the quality composition of the connective tissue collagen fibers by use of the polarization microscopy.
Results. The study of the structure of collagen fibers in the aponeurosis has been revealed that the bundles are seems to be heterogeneous, and each bundle is determined by the longitudinal pulpings. The obtained results of the study of architectonics aponeurosis in patients of the main group has been demonstrated the evidence the collagen fibers are arranged in the different directions and planes (42% of cases), branched out into individual thin fibers (53%), the interfiber spaces (67%) were significantly higher compared with the control group of architectonics aponeurosis.
Conclusion. Study of the collagen fibers structure in the skin and aponeurosis revealed heterogenous individual segments in patients with ventral hernias. At the same time the longitudinal pulping was found out in each separate bundle that testifies to more porous structure of the aponeurosis in patients with ventral hernias caused by the weakness of the anterior abdominal wall and promoted the development of hernia defects. Application of polarization microscopy method for the preoperative study of collagen fibers in the skin and aponeurosis enables to predict and carry out the additional prevention of hernias formation.

Keywords: ventral hernia, polarization light microscopy, collagen, skin, aponeurosis
p. 533-537 of the original issue
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Address for correspondence:
305041, Rossiyskaya Federatsiya,
g. Kursk, ul. K.Marksa, d.3,
GBOU VPO Kurskiy gosudarstvennyiy meditsinskiy universitet,
kafedra khirurgicheskih bolezney 1,tel.: 7 4712 35-36-90,
e-mail: ivanov.is@mail.ru,
Ivanov Ilya Sergeevich
Information about the authors:
Ivanov I.S., PhD, associate professor of the surgical diseases chair 1 of SBEE HPE Kursk State Medical University.
Lazarenko V.A., MD, professor of the surgical diseases chair of PTF of SBEE HPE Kursk State Medical University.
Ivanov S.V., MD, associate professor of the surgical diseases chair 1 of SBEE HPE Kursk State Medical University.
Sukhov G.M., assistant of the surgical diseases chair 1 of SBEE HPE Kursk State Medical University. Tcukanov A.V., assistant of the surgical diseases chair 1 of SBEE HPE Kursk State Medical University.
Goryanova G.N., PhD, associate professor of pathologic anatomy chair of SBEE HPE Kursk State Medical University.
Obedkov E.G., assistant of the surgical diseases chair 1 of SBEE HPE Kursk State Medical University.
Gafarov G.N., post-graduate student of the surgical diseases chair 1 of SBEE HPE Kursk State Medical University.
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