Novosti
|
This journal is indexed in Scopus |
|---|
Year 2013 Vol. 21 No 3
GENERAL AND SPECIAL SURGERY
E.M. MOKHOV, A.N. SERGEEV, E.V. SEROV
THE DEVELOPMENT OF NEW BIOLOGICALLY ACTIVE SUTURE MATERIALS AND USING THEM IN THE ABDOMINAL SURGERY
SBEE HPE “Tver State Medical Academy”
The Russian Federation
Objectives. Using morphological methods to estimate the reaction of the organism tissues and degradation processes of silicone implants after their application in clinical conditions.
Methods. The connective tissue capsules formed around various silicone mammary implants were studied by applying the method of light microscopy.
Results. It was revealed that after implantation of a volume soft foreign body (silicone mammary implants) this material presented in the tissues for a long period of time delimited by a fibrous capsule. Gradually the capsule compresses owing to the activity of myofibroblasts for minimization of the volume of an alien body, its internal surface is deformed and obtains a wavy form with a set of outgrowths or protrudes inside. The connective tissue capsule formed around silicone implants consists of dense (external, main) and friable (internal, boundary) parts. The tight part of a capsule isolates a foreign body from the organism tissues. A gradual destruction (fragmentation) and absorption of implant material by phagocytes occurs in friable part. Over time the silicone migrates to capsular tissues and out of its limits where it is absorbed by phagocytes. As the result of silicone migration in tissues and its uptake by phagocytes the volume of mammary implants gradually decreases and the capsule is reduced to meet the volume of the foreign body, the inner part of the capsule is wave-like deformed. A significant manifestation of granulomatous inflammation and the formation of a thick capsule with signs of fibrosis are considered as unfavorable prognostic signs pointing to a higher likelihood of developing various complications in the future.
Conclusions. The more inactive for a live organism the implant material is the less it will stimulate macrophage reaction. The problem of new implant design is in the search for the most bioinert materials, strong enough for compression by a capsule and fragmentation, but similar on elasticity with normal tissue of a mammary gland.
- Buianov VM, Egiev VN, Udotov OA. Khirurgicheskii shov [Surgical suture]. Moscow, RF: Medpraktika-M; 2001. 110 p.
- Semenov GM, Petrishin VL, Kovshova MV. Khirurgicheskii shov [Surgical suture]. 2 -e izd. Saint-Petersburg, RF: Piter; 2008. 256 p.
- Sleptsov IV, Chernikov RA. Uzly v khirurgii [Nodes in surgery]. 2 -e izd. Saint-Petersburg, RF: Medkniga, 2004. 112 p.
- Volenko AV, Men'shikov DD, Titova GP, Kuprikov SV. Profilaktika ranevoi infektsii immobilizirovannymi antibakterial'nymi preparatami [Prevention of wound infection by immobilized antibacterial agents]. Khirurgiia. 2004: 54–8.
- Plechev VV, Muryseva EN, Timerbulatov VM, Lazareva DN. Profilaktika gnoino-septicheskikh oslozhnenii v khirurgii [Prophylaxis of septic complications in surgery]. Moscow, RF: Triada-X, 2003. 320 p.
- Ming X, Nichols M, Rothenburger S. In vivo antibacterial efficacy of MONOCRYL plus antibacterial suture (Poliglecaprone 25 with triclosan). Surg Infect (Larchmt). 2007 Apr;8(2):209-14.
- . Suarez Grau JM, De Toro Crespo M, Docobo Durantez F, Rubio Chaves C, Martin Cartes JA, Docobo Perez F. Prevention of surgical infection using reabsorbable antibacterial suture (Vicryl Plus) versus reabsorbable conventional suture in hernioplasty. An experimental study in animals. Cir Esp. 2007 Jun;81(6):324–9.
- Volokna s osobymi svoistvami [Fibers with special properties]. red. Vol'f LA. Moscow, RF: Khimiia, 1980. 240 p.
- Zhukovskii VA, Khokhlova VA, Korovicheva SIu. Khirurgicheskie materialy s antimikrobnymi svoistvami [Surgical suture materials with antimicrobial properties]. Khim Volokna. 2007(2): 37-43.
- Tolstykh PI, Gostishchev VK, Virnik AD, i dr. Biologicheski aktivnye pereviazochnye i khirurgicheskie shovnye materialy. [Biologically active dressings and surgical suture materials]. Khirurgiia. 1988(4): 3–8.
- Korotkov NI, Efremov AV, Boitsov NI. Sravnitel'naia otsenka sovremennykh shovnykh materialov pri rezektsii zheludka [Comparative evaluation of modern suture materials at gastrectomy]. Khirurgiia Zhurn im NI Pirogova. 2002(11): 27–31.
- Mokhov EM, Sergeev AN. Vozmozhnosti i perspektivy primeneniia v khirurgii novogo biologicheski aktivnogo shovnogo materiala [Feasibility and prospects of application of new biologically active suture material in surgery]. Ros Med Zhurn. 2007(2):18–21
- Deliaert AE, Van den Kerckhove E, Tuinder S, Fieuws S, Sawor JH, Meesters-Caberg MA, van der Hulst RR. The effect of triclosan-coated sutures in wound healing. A double blind randomised prospective pilot study. J Plast Reconstr Aesthet Surg. 2009 Jun;62(6):771–73.
- Storch ML, Rothenburger SJ, Jacinto G. Experimental efficacy study of coated VICRYL plus antibacterial suture in guinea pigs challenged with Staphylococcus aureus. Surg Infect (Larchmt). 2004 Fall;5(3):281–88.
- Ming X, Rothenburger S, Nichols MM. In vivo and in vitro antibacterial efficacy of PDS plus (polidioxanone with triclosan) suture. Surg Infect (Larchmt). 2008 Aug;9(4):451–57.
170000, Rossiiskaia Federatsiia, g. Tver', ul. Sovetskaia, d. 4, GBOU VPO "Tverskaia gosudarstvennaia meditsinskaia akademiia", kafedra obshchei khirurgii,
e-mail: dr.nikolaevich@mail.ru,
Sergeev Aleksei Nikolaevich
Mokhov EM. MD, professor, a head of the chair of general surgery GBOU VPO "Tver State Medical Academy."
Sergeev AN. PhD, associate professor of general surgery chair GBOU VPO "Tver State Medical Academy."
Serov EV. A surgeon of Solnechnogorsk CRH of Moscow region, an applicant of general surgery chair GBOU VPO "Tver State Medical Academy."
Article in the .pdf format
