Collagen types ratio in prediction of postoperative ventral hernias

OBJECTIVES:Interest in elucidating the etiology of hernias has encouraged countless studies of musculoaponeurotic structures in individuals with and without hernias. Studies of hernia patients have firmly demonstrated a correlation between hernias and collagen alterations in their fascia. Diastasis recti is an increased width of the abdominal midline that is exclusively composed of interlacing aponeurotic expansions of the anterolateral abdominal muscles. The condition is common among women undergoing abdominoplasty, and many factors, not only mechanical, play a role. The goal of this study is to evaluate and compare collagen type I and III levels in the midline fascia of women with and without diastasis recti to report their possible influence on this condition.METHODS:This is a case-control study nested within a surgical cohort of 18 women with diastasis recti and 18 women without the condition (cases and controls, respectively). Fascia from the midline of the abdominal wall was collected and analyzed through immunohistochemistry using polyclonal antibodies to collagen type I and III.RESULTS:Both type I and type III collagen were less abundant in women with diastasis recti than in those without the condition, and the difference was statistically significant (p<0.001).CONCLUSION:Low collagen type I and type III levels in the midline of the abdominal wall may play a key role in the development of diastasis recti.

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“…Lazarenko et al studied collagen I and III levels in the skin and aponeuroses as a predictor of the risk of postoperative ventral hernia 11 .…”

Section: Discussionmentioning

confidence: 99%

Collagen I and III in women with diastasis recti

Blotta

Costa

Trindade

et al. 2018

Clinics

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“…A biological factor is of primary importance, which means connective tissue metabolic imbalance. Compared to normal patients, those with hernias are found to have collagen I and III ratio reduction in transverse fascia, aponeurosis, and the anterior abdominal wall skin, as well as an increased level of collagen matrix metalloproteinases [4,5]. The second group factors involve the errors in selecting suture materials and a technique to close laparotomy wounds, as well as surgeon's insufficient experience [6,7].…”

Section: Introductionmentioning

confidence: 99%

Prevention of Complications of Incisional Hernia Repair: Current Problem State (Review)

Parshakov¹,

Гаврилов²,

Самарцев³

2018

Sovrem Tehnol Med

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The review covers the important aspects of complications in incisional hernia repair. The paper specifies the most relevant issues of modern herniology, its social and economical aspects, considers the preventive techniques for preoperative, intraoperative and postoperative complications. When describing the preoperative predictive and preventive methods in complications, the authors analyzed the existent classifications and integral grading scales for patients' state indicators, showed the benefits and drawbacks of current techniques of preoperative preparation.The part devoted to an intraoperative period presents the main current hernia repair techniques, mesh implants, and their characteristics. Much attention is given to the description of surgical options depending on mesh arrangement in relation to anatomical abdominal wall layers, and the assessment of mesh implant types, their selection for a specific clinical setting. The review considers the principles of component separation as one of the most promising directions of abdominal surgery. When studying the postoperative preventive methods, the emphasis was made on the description of fast-track principles. Currently, a fast-track technique is being widely used in surgery, and gaining popularity in herniology.

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“…Коллагены являются главным компонентом экстрацеллюлярной матрицы, которая состоит из 28 различ-ных типов коллагена, гликопротеидов и протеогликанов. Нарушение синтеза коллагена I и III типов, а также металлопротеиназ 2, 9, 15 предрасполагает к образованию слабого рубца и в дальнейшем развитию послеоперационной грыжи [7].…”

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Влияние Аутоплазмы, Обогащенной Тромбоцитами, На Прочность И Эластичность Брюшной Стенки При Надапоневротической Имплантации Легкого Полипропиленового Эндопротеза (Экспериментальное Исследование)

Суковатых¹,

Zatolokina²,

Мутова³

et al. 2018

Курск. науч.-практ. вестн. «Человек и его здоровье»

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1 Кафедра общей хирургии, 2 кафедра гистологии, эмбриологии, цитологии, 3 кафедра хирургических болезней № 2, 4 кафедра хирургии ФПО Курского государственного медицинского университета, Курск; 5 ООО «Линтекс», Санкт-Петербург E-mail: SukovatykhBS@kursksmu.net Представлены результаты экспериментального исследования на кроликах породы шиншилла брюшной стенки после ее надапоневротического эндопротезирования легким полипропиленовым эндопротезом без и после введения в зону имплантации аутоплазмы, обогащенной тромбоцитами. Изучение прочности и эластичности брюшной стенки проводили на разрывной машине РЭМ-02-1. Регистрировали показатели относительного удлинения при стандартной и разрывной нагрузке, разрывную нагрузку ткани. Результаты исследования показали, что в ведение аутоплазмы, обогащенной тромбоцитами, позволяет увеличить эластичность и прочность брюшной стенки. Разработанная технология стимуляции репаративных процессов в ткани брюшной стенки АпОТ при ее эндопротезировании проста в техническом выполнении, экономически целесообразна, безопасна для реципиентов. Проведенные исследования позволяют рекомендовать стимуляцию репаративных процессов при герниопластике аутоплазмой, обогащенной тромбоцитами, для дальнейших клинических испытаний.Ключевые слова: брюшная стенка, легкий полипропиленовый протез, стимуляция репаративных процессов, обогащенная тромбоцитами аутоплазма, биомеханические свойства. The results of the experimental study of the abdominal wall after supraaponeurotic endoprosthesis with a lightweight polypropylene implant with and without introducing autoplasma enriched with platelets into the implantation zone conducted on chinchilla rabbits. The study of the abdominal wall strength and elasticity was carried out with a tensile testing machine REM-02-1. The indicators of relative elongation in standard and breaking load were recorded as well as the breaking load of tissue. The results of the study showed that introduction of autoplasma enriched with platelets can increase the elasticity and strength of the abdominal wall. The developed technology of stimulation of reparative processes in the abdominal wall tissue after endoprosthesis is technically simple, economically feasible and safe for patients. The conducted researches allow recommending the stimulation of reparative processes in hernioplastica with autoplasma enriched with platelets for further clinical tests.

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Collagen types ratio in prediction of postoperative ventral hernias

Abstract: In patients with ventral hernias collagen type I/III ratio in skin is 2.54 times lower than in patients without hernias. Significant correlation of collagen types in skin and aponeurosis (r= +0.92) allows to predict the risk of postoperative ventral hernias on basis of skin fragment.

Cited by 3 publications

References 9 publications

Collagen I and III in women with diastasis recti

Collagen I and III in women with diastasis recti

Prevention of Complications of Incisional Hernia Repair: Current Problem State (Review)

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