Immunohistochemical evaluation of fibrillar components of the extracellular matrix of transversalis fascia and anterior abdominal rectus sheath in men with inguinal hernia

Gonçalves, Rogério de Oliveira; Silva, Evandro de Moraes e; Filho, Gaspar de Jesus Lopes

doi:10.1590/s0100-69912014000100006

Cited by 11 publications

(7 citation statements)

References 21 publications

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“…For a long time, numerous studies have been developed to search for causes and best method of treatment 1 , 20 . The causes of failure in bringing the abdominal walls together are important research topics 12 , 13 . The incidence of abdominal wall defects in obese patients is high, reaching 30% after laparotomy.…”

Section: Introductionmentioning

confidence: 99%

Linea Alba Collagen Assessment in Morbidly Obese Patients

Grossi

Nicola

Zepeda

et al. 2016

ABCD, arq. bras. cir. dig.

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Background:The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy. Aim: To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers. Methods:Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group). The samples were collected in 2013 and 2104, and were sorted according to age (18-30, 31-45 and 46-60), gender, BMI, waist and cervical circumference, and subcutaneous tissue thickness. Material for biopsy was collected from the supraumbilical region of the linea alba for immunohistochemical analysis differentiating collagen type 1 and type 3 and the 1/3 ratio. Image-Pro Plus pixel counting software was used to measure the amount of collagen. Results:The obesity group evidenced mean age 44.11±9.90 years; 18-30 age group had three (6.8%) obese individuals; 31-45 had 22 (50%) and 46-60 had 19 (43.1%). Females were present in 81.8% (n=36); BMI (kg/m²) was 48.81±6.5; waist circumference (cm) was 136.761±13.55; subcutaneous tissue thickness (cm) 4.873±0.916. Considering age groups, gender and BMI, there were statistical differences in all tests when compared with the cadavers. Conclusion:The amount of collagen in the linea alba above the umbilical region in the morbidly obese patients was smaller than in the non-obese cadavers in the same age group.

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Section: Introductionmentioning

confidence: 99%

Linea Alba Collagen Assessment in Morbidly Obese Patients

Grossi

Nicola

Zepeda

et al. 2016

ABCD, arq. bras. cir. dig.

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“…The research concluded that the amount of fibrillar components of the extracellular matrix was not alterated in patients with and without inguinal hernia 14 . …”

Section: Discussionmentioning

confidence: 97%

Influence of Tobacco, Alcohol and Diabetes on the Collagen of Cremaster Muscle in Patients With Inguinal Hernias

Modena

Caldeira

Peres

et al. 2016

ABCD, arq. bras. cir. dig.

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Background: New findings point out that the mechanism of formation of the hernias can be related to the collagenous tissues, under activity of aggressive agents such as the tobacco, alcohol and diabetes. Aim: To analyze the collagen present in the cremaster muscle in patients with inguinal hernias, focusing the effect of tobacco, alcohol, and diabetes. Methods: Fifteen patients with inguinal hernia divided in three groups were studied: group I (n=5) was control; group II (n=5) were smokers and/or drinkers; and group III (n=5) had diabetes mellitus. All subjects were underwent to surgical repair of the inguinal hernias obeying the same pre, intra and postoperative conditions. During surgery, samples of the cremaster muscle were collected for analysis in polarized light microscopy, collagen morphometry and protein. Results: The area occupied by the connective tissue was higher in groups II and III (p<0.05). The collagen tissue occupied the majority of the samples analyzed in comparison to the area occupied by muscle cells. The content of total protein was higher in groups II and III compared to the control group (p<0.05). Conclusion: The tobacco, alcohol and diabetes cause a remodel the cremaster muscle, leading to a loss of support or structural change in this region, which may enhance the occurrences and damage related to inguinal hernias.

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“…These differences could be related to the role played by collagen fibres on the appearance of diastasis recti and hernias (Blotta et al 2018 ; Mosanya et al 2020 ). Different proportions of collagen fibres have been reported in the anterior rectus sheath of different ethnic populations, namely, an African Nigerian population (Mosanya et al 2020 ), South-American Brazilian population (Casanova, Trindade & Trindade 2009 ; Gonçalves, De Moraes E Silva & Lopes Filho 2014 ) and a European Portuguese population (Blotta et al 2018 ). To move forward on that issue, a study should be designed to compare different ethnic populations regarding histological characteristics of the abdominal wall in postpartum women with and without diastasis recti.…”

Section: Discussionmentioning

confidence: 99%

Diastasis recti in the Beninese population: Cross-sectional study from normal values to diagnosis

Djivoh

Kpadonou

Puttemans

et al. 2022

South African Journal of Physiotherapy

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Background: Diastasis recti is diagnosed when the interrecti distance (IRD) is larger than a threshold value. Published thresholds were measured at rest with ultrasound while in Benin physiotherapists use calipers during abdominal contraction.Objectives: The aim was to define IRD threshold values measured with calipers in Beninese participants in order to diagnose diastasis recti in a clinical environment and identify women needing abdominal rehabilitation.Method: Interrecti distance was measured using ultrasound and calipers. Linea alba stiffness was assessed by palpation, abdominal strength and endurance by manual testing. In men and nulliparous women, IRD threshold values were defined as IRD P90. In postpartum women, IRD P80 and a threshold defined with a receiver operating characteristics (ROC) curve based on linea alba stiffness were used. In these women, abdominal strength and endurance were compared depending on IRD threshold and linea alba stiffness with a Mann Whitney test.Results: In 391 Beninese participants, the IRD threshold measured with calipers was 17 mm in men, 15 mm in nulliparous and 18 mm (15 mm with ROC curve) in postpartum women. Postpartum women with an IRD above 18 mm had significantly lower abdominal strength. Those with a slack linea alba had significantly lower abdominal strength and endurance.Conclusion: The defined IRD threshold values can be used in a Beninese clinical environment. Future studies should confirm whether they can be applied to other African populations.Clinical implications: Abdominal rehabilitation should be recommended to postpartum women whose IRD is above the threshold values but also in cases of slack linea alba and poor abdominal function.

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Immunohistochemical evaluation of fibrillar components of the extracellular matrix of transversalis fascia and anterior abdominal rectus sheath in men with inguinal hernia

Abstract: the amount of fibrillar extracellular matrix components did not change in patients with and without inguinal hernia.

Cited by 11 publications

References 21 publications

Linea Alba Collagen Assessment in Morbidly Obese Patients

Linea Alba Collagen Assessment in Morbidly Obese Patients

Influence of Tobacco, Alcohol and Diabetes on the Collagen of Cremaster Muscle in Patients With Inguinal Hernias

Diastasis recti in the Beninese population: Cross-sectional study from normal values to diagnosis

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