Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10264

Study of differences in the biomechanical properties of samples of postoperative scars

Kutsenko

Аndrew Vladimirovich

andreyla.kutsenko@yandex.ruhttps://orcid.org/0009-0002-5203-0087Rudneva

Julia Denisovna

julia.rudneva.03@mail.ruhttps://orcid.org/0009-0000-4284-3012Chernykh

Alexander Vasilyevich

D.М., Professor, Head of the Department of Operative Surgery with Topographic Anatomychernyh@vrngmu.ruhttps://orcid.org/0000-0002-6281-0020Shevtsov

Artyom Nikolaevich

C.М., Associate Professor of the Department of Operative Surgery with Topographic Anatomyshan-87@yandex.ruhttps://orcid.org/0000-0001-8641-2847Magomedrasulova

Asiyat Abdulnasirovna

Assistant of the Department of Operative Surgery with Topographic Anatomyordinatura@vrngmu.ruhttps://orcid.org/0000-0002-3158-1480

Voronezh State Medical University named after N.N. Burdenko

30062025

141101103

19022025

25032025

2025

It is known that any tissue of the human body is capable of displaying plastic properties, i.e. it can stretch or contract [1,2]. Under the influence of the force that acts on the tissue, tissue deformations occur, represented by the following stages: 1 the zone of initial deformation; 2 the zone of plastic deformation; 3 the zone of terminal deformation; 4 the average critical point; 5 the rupture zone. [3]. When performing operations on the anterior abdominal wall after suturing the wound and reducing the load on the tissue, stress relaxation phenomena occur: the tissue demonstrates the properties of elasticity and firmness. These processes occur due to the peculiarities of the histoarchitectonics of tissues of different topographic anatomical regions [4]. The presented processes have found a response in the scientific literature, however, no studies have been found on the differences in the biomechanical properties of postoperative scars. Goal. To identify differences in the integrity of the postoperative scar in the studied samples in the conditions of an infected and clean wound. Materials and methods. For this purpose, a study of 180 samples of postoperative scars previously operated on at the VSMU (Voronezh) rats, on a bursting electromechanical machine in accordance with GOST 8847-85 in the laboratory of KSMU (Kursk). Results. The tensiometry of samples obtained using various methods of hernial defect plastic (plastic with local tissues, PP (polypropylene mesh), DBT (decellularized bioengineered graft) showed that in the samples of "clean" and "infected" wounds with a standard load (16 N) in the longitudinal and transverse directions, the highest extensibility was observed in the case of using DBT. Conclusions. These data indicate that the use of DBT promotes the formation of scar tissue with high-quality mechanical properties, which may be a key factor in improving the effectiveness of postoperative recovery and reducing the risk of complications.

Introduction. It is known that any tissue of the human body is capable of displaying plastic properties, i.e. it can stretch or contract [7]. Under the influence of the force that acts on the tissue, the tissue is deformed. During surgery, the surgeon is faced with the question of which plastic surgery method to use in order to increase the effectiveness of postoperative recovery and reduce the risk of complications. This work is devoted to the study of the properties of the fibers of the matrix of a postoperative scar, which ultimately will give certain ideas about which method of plastic surgery contributes to the formation of scar tissue with high-quality mechanical properties. The purpose of the work. To identify differences in integrity indicators in the studied samples of postoperative scars in infected and clean wounds. Materials and methods of research. The biomechanical properties of scar tissue fragments from the anterior abdominal wall of 180 rats operated on for a herniated disc using various plastic surgery methods (local tissues, PPSS (polypropylene mesh), DBT (decellularized bioengineered graft)) The results of the study. In all operated animals, when they were removed (on the 30th and 180th days after surgery) from the experiment, a fragment of PBS was taken with mandatory capture of a site with DBT or PPP, or with a plastic area with local tissues in the form of rectangular flaps, 4-5 x 2-1.5 cm in size, containing a postoperative scar, which during During transportation to the laboratory of KSMU (Kursk), they were stored in a container with a cooled saline solution. Further study of the biomechanical properties of the postoperative anterior abdominal wall scar included an assessment of the absolute elongation of tissues with extensibility in the transverse and longitudinal directions on a bursting electromechanical machine in accordance with GOST 8847-85. During the tests, elongation at a standard load of 16 N and the load at which the samples ruptured were used as criteria. When analyzing the results, it was assumed that elongation at standard load characterized the elastic properties of the prosthetic aponeurosis, and the breaking load indicated its strength properties. From the values obtained in this way, the average elongation (elasticity) values were calculated, which were expressed as a percentage, and the average breaking load (strength) values were in N. To compare the experimental groups with the initial biomechanical properties of DBT and PPP before their implantation into the tissue, an intact polypropylene mesh with dimensions 4-5 x 1.5-2 and fragments of PBB with dimensions 9 1.5 x 11 1.5, obtained during autopsy of 2 male rabbits of the White Giant" breed and decellularized with 2% SDS solution according to the developed protocol, and divided into rectangular flaps measuring 4-5 x 1.5-2 cm . The structure of the studied groups is presented in Table 1. Table 1. The structure of the groups operated on. <table width="641"> <tbody> <tr> <td rowspan="2" width="68"> plastic surgery with local tissues </td> <td width="76"> 15 </td> <td width="89"> 30 </td> <td rowspan="2" width="68"> plastic surgery with local tissues </td> <td width="76"> 15 </td> <td width="76"> 30 </td> <td rowspan="6" width="102"> n=10 </td> <td rowspan="6" width="87"> n=10 </td> </tr> <tr> <td width="76"> 15 </td> <td width="89"> 180 </td> <td width="76"> 15 </td> <td width="76"> 180 </td> </tr> <tr> <td rowspan="2" width="68"> plastic PPS </td> <td width="76"> 15 </td> <td width="89"> 30 </td> <td rowspan="2" width="68"> plastic PPS </td> <td width="76"> 15 </td> <td width="76"> 30 </td> </tr> <tr> <td width="76"> 15 </td> <td width="89"> 180 </td> <td width="76"> 15 </td> <td width="76"> 180 </td> </tr> <tr> <td rowspan="2" width="68"> plastic DBT </td> <td width="76"> 15 </td> <td width="89"> 30 </td> <td rowspan="2" width="68"> plastic DBT </td> <td width="76"> 15 </td> <td width="76"> 30 </td> </tr> <tr> <td width="76"> 15 </td> <td width="89"> 180 </td> <td width="76"> 15 </td> <td width="76"> 180 </td> </tr> </tbody> </table> The Kraskell-Wallis H-test was used to assess the significance of differences between groups, the median (Me) was used as a measure of the central trend, and the quartile interval (Q1-Q3) was used as a measure of variability. The results of the study of samples obtained from the groups of the 2nd stage of the study - plastic surgery of the anterior abdominal wall of laboratory animals under clean wound conditions, on the 30th (N=49.014, at p0.001, N=53.063, at p0.001) and 180th (N=55.009, at p0.001, H=53.812, at p0.001) day after surgery, it was shown that at standard load (16 N) in the longitudinal and transverse directions, the highest extensibility index was observed in the 4th control group (intact polypropylene mesh), while the lowest index was recorded in the 1st the experimental group (scar with local tissues). The most durable and elastic scars on the 30th and 180th days after surgery were those that formed after plastic surgery using a biograft and a mesh prosthesis. These data indicate that the use of DBT promotes the formation of scar tissue with high-quality mechanical properties, which may be a key factor in improving the effectiveness of postoperative recovery and reducing the risk of complications. When studying the biomechanical properties of scars formed in an infected wound, the following results were obtained: on the 30th day after plastic surgery, the most elastic scars in the longitudinal and transverse directions under standard load were in the group where a bioengineered graft was used. The longitudinal and transverse rupture study showed the highest results in the group where plastic surgery was performed using a decellularized bioengineered graft. In the group where a mesh prosthesis was used, on the 30th day after surgery, in 5 cases (33.5%), when a fragment of scar tissue was stretched, the PPS exfoliated from the soft tissues, which indicates an unsatisfactory process of mesh integration into the PBS tissues. Tensiometry of the scars on the 180th postoperative day showed that the maximum strength and elasticity was achieved during the repair of a hernial defect using a biotransplant. Conclusion. The data obtained indicate that the use of DBT promotes the formation of scar tissue with high-quality mechanical properties, which may be a key factor in improving the effectiveness of postoperative recovery and reducing the risk of complications.

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