Histological manifestations in the structures of the anterior abdominal wall after implantation of the acellular dermal matrix using the sublay method.

Abstract

Objective: Aim: The objective of this study was to assess the level of vascularization, integration of the acellular dermal matrix, as well as the development of granulation tissue and collagen fibers following implantation on the anterior abdominal wall ("sub lay") in pigs over the course of 7, 14, and 21 days.

Patients and methods: Materials and Methods: The experiment was conducted on six pigs of the Ukrainian White steppe. Under general anesthesia, an acellular perforated dermal matrix from pigs, produced by the ≪Institute of Biomedical Technologies≫, was implanted into the anterior abdominal wall, between the aponeurosis and muscles. The quality of engraftment, degree of angiogenesis, condition of granulation tissue, and graft structure were assessed. The postoperative period was uncomplicated, with each pig receiving one intramuscular dose of ceftriaxone (1.0). Material was collected from two pigs on the 7th day, two more on the 14th day, and the final two on the 21st day after implantation. Pathomorphological analysis was carried out in the laboratory of I. Horbachevsky Ternopil National Medical University. Sections of the implanted material, stained with hematoxylin-eosin, were evaluated for local inflammation reactivity, vascularization levels, and granulation tissue replacement.

Results: Results: The research findings revealed that, after 7 days of implantation, the acellular skin matrix "sub lay" led to infiltration caused by acute inflammation, accompanied by the formation of granulation tissue, numerous microcirculatory vessels, and collagen fibers. By day 14, the signs of inflammation had reduced, and there was an increase in fibroblasts and blood vessels. On day 21, the implantation process intensified, marked by a rise in collagen fibers and vascularization, along with a decrease in macrophages and lymphocytes. No signs of infection were observed.

Conclusion: Conclusions: Acellular dermal matrix after ≪sub lay≫ implantation causes acute inflammation with slow vascularization in the early period with a moderate increase up to 14 and 21 days. The implant acts as a base to support the migration of natural cells and subsequent replacement by granulation tissue, as a result of strengthening this area. No signs of infection were detected, which gives hope for the use of implants in previously infected environments after complications due to the implantation of meshes made of artificial materials before.