Application of the plasm, enriched by thrombocytes for prophylaxis of late complications and the pain syndrome after hernioplasty

Keywords: plasm, enriched with thrombocytes; regenerative cytokines; the polypropylene mesh implant; the periprosthesis fibrosis; the pain syndrome; biomechanical dysfunction

Abstract

Objective. To lower the late complications severity in patients, operated for cicatricial abdominal hernias, due to application of plasm, enriched by thrombocytes (PETH).

Materials and methods. In clinical investigation, conducted in Surgical Department of Centre of Reconstructive and Restoration Medicine (the University Clinic) of the Odessa National Medical University in 2013 - 2019 yrs, were included 84 patients, operated for cicatricial abdominal hernias. Average age of the patients have constituted (60.1 ± 7.6) yrs, the hernia gate size - 8.2 cm, average value of BMI - 31.8 kg/m2. The standard volume of operative intervention was done in patients in accordance to indications: hernia incision, hernioplasty of anterior abdominal wall, using a lightweight (80 g/m2) polypropylene mesh. In the main group of patients after hernioplasty the prosthesis implantation zone was infiltrated with activated autologous PETH, which was prepared, using double centrifugation, in the 14 - 38 ml volume. In patients of the control group the PETH was not performed. The patients’ quality of life was estimated, using the standard questionnaire SF-36 preoperatively, and postoperatively. Questionnaires DN4 and ID Pain were applied with the objective to differentiate the neuropathic pain.

Results. In the patients of both groups the raising of the quality of life indices was noted in postoperative period. Statistical trustworthiness of the indices was higher in patients with the supraaponeurosis localization of the prosthesis. The indices of physical health and associated indices of social activity and general level of health have demonstrated a significantly higher level of the life quality in the patients of the main group. Index of the general health state in patients after the supraaponeurosis hernioplasty, using PETH, was trustworthily higher, then in the control group - accordingly, 69.3 ± 3.8 and 59.7 ± 4.1 (p < 0.05).

Conclusion. The infiltration procedure of the soft tissues, having a contact with polypropylene mesh, is secure, do not trustworthily enhance the risk for occurrence of local and systemic complications. The procedure proposed, due to the reparative processes modification in the hernioplasty zone, promotes the prosthesis integrationa, reduces the risk for development and severity of biomechanical disorders, impacting positively the patients’ quality of life. The procedure efficacy is statistically trustworthily higher in patients after the supraaponeurosis hernioplasty.

Author Biographies

A. I. Tkachenko, Odessa National Medical University

Alexander Tkachenko
Doctor of Medicine, Professor
Head of Surgery Department # 4 with oncology course
Odessa National Medical University
65009 Odessa region, Odessa city, str. Shady, 8
+380503366933
doctortkachenko@i.ua
http://orcid.org/0000-0001-7929-0220

S. G. Chetverikov, Odessa National Medical University

Sergiy Chetverikov
Prof. Surgery dept № 4 with oncology course
Odessa National Medical University
2 Valichovskiy lane, Odesa. Ukraine, 65082
dmitriyatanasov@gmail.com
https://orcid.org/0000-0001-6280-8054

D. V. Atanasov, Odessa National Medical University

Dmitro Atanasov
Surgery dept № 4 with oncology course
Odessa National Medical University
2 Valichovskiy lane, Odesa. Ukraine, 65082
dmitriyatanasov@gmail.com
0679065653
dmitriyatanasov@gmail.com
https://orcid.org/0000-0003-4349-9131

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Published
2019-08-29
How to Cite
Tkachenko, A. I., Chetverikov, S. G., & Atanasov, D. V. (2019). Application of the plasm, enriched by thrombocytes for prophylaxis of late complications and the pain syndrome after hernioplasty. Klinicheskaia Khirurgiia, 86(8), 13-20. https://doi.org/10.26779/2522-1396.2019.08.13
Section
General Problems of Surgery