Features of tissue healing of laparotomy wounds after cesarean section in obesity 

Elena A. Davydova, Postgraduate student, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia)
Aleksey P. Vlasov, Doctor of medical sciences, professor, head of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: vap.61@yandex.ru
Alina E. Markina, Applicant of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia)
Tatyana I. Vlasova, Doctor of medical sciences, associate professor, head of the sub-department of normal and pathological physiology, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: v.t.i@bk.ru
Darya G. Sardaeva, Applicant of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: sardaieva96@mail.ru 

Background. Recently, the number of cesarean section deliveries has increased, which increases the risk of postoperative complications. One of the important risk factors is obesity, which significantly complicates the healing of laparotomy wounds. The purpose of the study was to establish a link between the degree of obesity and the presence of complications after abdominal delivery. Materials and methods. 65 pregnant women were examined after delivery by cesarean section. In accordance with the purpose of the work, three groups are identified. In the first group there were women with normal body weight, in the second group there were women with grade I obesity (body mass index over 30), in the third group there were women with grade III obesity (body mass index over 40. The obtained digital data were processed by the method of variational statistics using the Student's t criterion. Results. In obese patients, repair of abdominal wall tissue structures after cesarean section in the early postoperative period was slower and more imperfect. The analysis of the obtained cytological material showed that the course of incomplete reparative regeneration of abdominal wall tissues in obesity occurred against the background of prolongation of the inflammatory phase, revealed by the analysis of the results of cytological examination. The prolongation of the inflammatory phase, therefore, and the low rate of tissue regeneration in the wound area in obesity were indicated by a low regenerative-degenerative index, which is determined by the ratio of normal and degenerative forms of these shaped elements. Conclusions. In obese women who have undergone cesarean section delivery, the healing process of a laparotomy wound proceeds slowly, especially in the third degree. This is documented by a marked decrease in the degenerative-degenerative index, a slowdown in the transformation of polyblasts into tissue forms – precursors of connective tissue elements. One of the factors reducing the rate of tissue repair along the suture line in obese patients after cesarean section are dysmicrocirculatory phenomena, which are most pronounced in third degree obesity. 

obesity, tissue repair, leukocytes, inflammatory phase, cesarean section 

Davydova E. A., Vlasov A. P., Markina A. E., Vlasova T. I., Sardaeva D. G. Features of tissue healing of laparotomy wounds after cesarean section in obesity. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2024;(3):175–186. (In Russ.). doi: 10.21685/2072-3032-2024-3-15