PLASTICS OF THE VENTRAL HERNIUM WITH THE IMPLANT: THE REACTION OF THE NEU-ROMUSCULAR ENDINGS OF THE FRONT AB-DOMEN WALL

Aim: to evaluate the restructuring of the neuromuscular endings in the area of plasty of large ventral defects. Materials. The work is based on the evaluation of the structural rearrangement of the neuromuscular component of the anterior abdominal wall after the aloplasty of a significant ventral defect with the use of a prolene implant. Histological examination was performed in 20 rats at 1, 2 and 3 months after implantation. The relative and absolute indices of neuromuscular junction were determined morphometrically. Results. The study found that the mechanical stress of the musclе-aponeurotic layer of the abdominal wall when stretching and comparing the edges of the experimental defect is an important factor that leads to an increase in the scarring time and also causes permanent degenerative processes of the neuro-muscular-aponeurotic structures. This is accompanied by dys-trophic phenomena of the neuro-muscle-aponeurotic layer of the anterior abdominal wall with the greatest clarity of pathological changes towards the end of the first month after alloplasty. The use of a prolenic implant for plastics without mechanical stress of the neuromuscular structures allows to significantly optimize the course of restorative-adaptive processes within 3 months of the postoperative period, which is confirmed by the corresponding electromyographic parameters. Conclusions. The quantitative morphofunctional analysis made it possible to determine the stress of adaptation processes of the peripheral nervous apparatus in the muscles of the abdominal wall when the edges of the hernia defect were compared. This can be regarded as an important factor that led to an increase in the duration of scarring and caused stable degenerative changes in the neuromuscular structures. This postoperative disadaptation was accompanied by dystrophic changes in muscle fibers, which was confirmed by electroneu-ronographic indicators. The peak of these processes in the com-ponents of the anterior abdominal wall with the maximum exac-erbation of pathological changes has been noted in the period from the third month after the operative intervention. The use of a proline prosthesis in conditions of minimizing the mechanical stress of the muscular-aponeurotic structures makes it possible to optimize significantly the course of restorative-adaptive processes at remote times after alloplasty due to the restoration of the morpho-functional features of the neuromuscular endings.