The aim of this study was to examine the collagen-stimulating effect of ascorbic acid on the growth of the Parieten ProGrip implanted synthetic hernia prosthesis. The characteristics of collagenogenesis in the anterior abdominal wall were assayed with polarized microscopy. We suggest a new way to stimulate a reparation process with ascorbic acid that will help to optimize forming functionally matured structures of connective tissue of the anterior abdominal wall surrounding endoprosthesis. The results of our investigation show that vitamin C has a positive effect on the collagen synthesis in the periprosthetic capsule for any type of endoprosthesis. This was proven by the statistically significant increase in the ratio of collagen I and III types with vitamin C to the animal diet.

The aim of the study was to learn the degree of biocompatibility of synthetic herniological prostheses«Progrip», with collagen-stimulating effect of ascorbic acid on the growth of connective tissue in the experiment.We examined characteristics of collagenogenesis in the anterior abdominal wall depending on the effectof vitamin C using the method of polarization microscopy. We suggest a new way to stimulate reparation processby ascorbic acid which would help to optimize forming functionally matured structures of connective tissueof the anterior abdominal wall surrounding endoprosthesis. Due to the results of our investigation it has beenclear that modification effect of vitamin C is positive for synthesis of collagen in the periprosthetic capsulefor any type of endoprosthesis. It has been proves by statistically reliable increase in ratio of collagen types Iand III when vitamin C is used in the diet of experimental animals.

A clinical case of treatment of 57-year-old patient suffering from the irreducible giant inguinal-scrotal hernia is presented. On admission the patient complained on the marked abdominal wall defects, abnormal enlargement of the scrotum and inability to care for self. For the first time hernia protrusion appeared 11 years ago and has been gradually increased. The patient noticed the most intensive growth of the hernia within last 1,5 years. The left-side inguinal-scrotal herniotomy, Liechtenstein’s plastics, endoprosthetics of the anterior abdominal wall with the polypropylene surgical net (in-lay method combined with the elements of Ramirez operation) have been performed. There were no complications in the post-operation period. The excision and plastics of the scrotum are planned to perform as the second step in six months. Taking into consideration the peculiarity of the case (giant size of the hernia protrusion and difficulties in surgical treatment) it was decided to use a complex of surgical methods while treating this pathology. Thus the development of compartment syndrome and post-operative complications has been avoided. As a result the efficacy improvement of the performed treatment was achieved. The presented case is interesting as the demonstration option of an operative repair of the giant irreducible inguinal-scrotal hernia.

One of the problems of modern surgery is treatment of ventral hernias. It is important to study the process of wound healing in the area of implantation of prosthesis depending on the drugs use that improve the processes of regeneration and repair, in particular ascorbic acid. We carried out the experimental study of 200 white mice with the implanted prosthesis Esfil and ProGrip whose diet included ascorbic acid. The inflammatory response was less pronounced after using ascorbic acid and reached its minimum with endoprosthesis material ProGrip. There was significantly higher content of fibroblasts in the connective tissue capsule after the combined use of the endoprosthesis ProGrip and ascorbic acid.

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The disorders of collagen development and collagen type ratio in the connective tissue play the major role in developing hernia. To investigate the peculiarities of the collagen structure 134 patients divided into 2 groups were examined. The first group consisted of 85 patients, suffering from anterior abdominal wall hernias, and 49 patients of the second group showed neither signs of hernia nor connective tissue dysplasia. The investigation of the collagen fiber structure revealed that the bands of fibers are heterogeneous; each of them possesses longitudinal fibrillation. The collagen fibers of aponeurosis in patients with hernias are porous that leads to the anterior abdominal wall weakness and contributes to hernias development.

Nowadays ventral hernias still remain the actual problem of abdominal surgery. The disorders of collagen formation and collagen types ratio in the connective tissue play the major role in the pathogenesis of ventral hernias. The peculiarities of collagen structure in the skin and aponeurosis were investigated in 95 patients with and without ventral hernias. All patents were divided in two groups.The first group included 46 patients, suffering from the anterior abdominal wall hernias, the patients of the second group presented no signs of hernia disease or signs of connective tissue dysplasia. The specimens of the skin and aponeurosis were taken during planned surgical operations. They were used for the investigation of the quality contents of the connective tissue collagen fibers.The specimens were stained with Sirius Red dye, and investigated with the usage of polarization microscope Altami Polar 2, magnification x250 (sic) x400, in ordinary and polarization regimes. Photos of microspecimens were made with digital ocular camera Altami 3 Mpx., there were taken 10 fields of view in each magnification. Analysis of the results was fulfilled with MS Excel program.The investigation of collagen fibers presented the heterogeneity of their structure. In each bunch of fibers there were found longitudinal fibrillation. The comparison of the results of aponeurosis architecture investigation in patients with anterior abdominal wall pathology revealed that in the control group (patients with ventral hernias) collagen fibers are localized in different directions and plans in 42% of all cases, in 53% the collagen fibers were branching in separate thin fibers, in 63% of the main group patients interfiber spaces are significantly more in sizes in comparison with the aponeurosis architecture in patients of the control group (without ventral hernias). The patients with the hernias of the anterior abdominal wall possess lower index of collagen fibers density and interfiber spaces in the skin in comparison with patients without this pathology.The collagen fibers of aponeurosis in patients with ventral hernias possess more porous structure. This causes weakness of the anterior abdominal wall and leads to hernia defects formation.