Functional and metabolic state of regenerating structures after hernioplasty depending on the type of herniaFunctional
and metabolic state of regenerating structures after allogernioplasty depending on the type of hernias 

Rustam Kh. Azimov, Candidate of medical sciences, head of the department of surgery, Central Clinical Hospital of the Russian Academy of Sciences (1A Litovskiy boulevard, Moscow, Russia),doc_rustam@rambler.ru
Viktor A. Gorskiy, Doctor of medical sciences, professor, professor of the sub-department of experimental and clinical surgery, faculty of medicine and biology, Pirogov Russian National Research Medical University (1 Ostrovityanova street, Moscow, Russia), gorviks@yandex.ru
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), vap.61@yandex.ru
Oleg Yu. Rubtsov, Doctor of medical sciences, professor, professor 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), rubsov-61@yandex.ru
Kirill A. Shemyatovskiy, Candidate of medical sciences, surgeon of the department of surgery, Central Clinical Hospital of the Russian Academy of Sciences (1A Litovskiy boulevard, Moscow, Russia), doc_rustam@rambler.ru

Background. There are still questions about the plastic material for gernioplasty. This determines the relevance of the search for optimal, clinically appropriate material. The purpose of the work is to study the functional and metabolic state of tissues in the area of herniation in inguinal hernias of varying severity using a polypropylene graft. Materials and methods. Clinical and laboratory examination was carried out in 58 patients with inguinal hernias who used polypropylene mesh for Lichtenstein hernioplasty. Two groups of patients were identified. To divide patients into groups by the Nyhus classification (1993). In the first group of patients, inguinal hernias were type II (n=38), in the second (n=20) – type III (III A, III B) or IV (IV A, IV B). Results. The conducted studies have shown that in the early postoperative period, during herniation using a mesh polypropylene implant, a sufficiently pronounced inflammatory reaction and microcirculation disorders occur from the tissue structures of the wound and tissues captured by the suture material. Their degree of severity is associated with the type of hernias. In grades III and IV, they are more pronounced and prolonged than in type II and generally indicated greater tissue alteration and a slowdown in the reparative phase. This functional and structural circumstance could not but affect the occurrence of wound complications in the early postoperative period and the condition of the graft in the long term. Conclusions. The data obtained largely provide the basis for finding ways to improve gernioplasty. Firstly, less tissue injury is postulated during surgical manipulations, and secondly, there is an urgent need to find new transplants with fewer side effects. 

Lichtenstein hernioplasty, polypropylene mesh, repair, inflammation 

Azimov R.Kh., Gorskiy V.A., Vlasov A.P., Rubtsov O.Yu., Shemyatovskiy K.A. Functional and metabolic state of regenerating structures after allogernioplasty depending on the type of hernias. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2022;(3):75–83. (In Russ.). doi:10.21685/2072-3032-2022-3-7