One of the major problems of general surgery is the problem of postoperative abdominal adhesions. Biologically expedient response, aimed at the localization of the pathological process, is often the cause of illness and severe complications. We purposefully studied some aspects of adgeziogeneza. As a result of lessons learned: no matter what the mechanism of injury, adhesions have a typical organization, adhesions - stage process, the likelihood of adhesions depends on the speed mezotelizatsii defect the peritoneum and its fibrinolytic activity. Adhesion formation is both a protective and adaptive and pathological phenomena can not be considered until the end of the studied and requires further investigation.
Summery:
The problem of development of postoperative adhesion formation of abdominal brand viagra online concavity is one of the basic problems of general surgery. The biologically expedient response, directional on localization of pathological process, frequently becomes a reason of illness and serious complications. In work some parties of adhesiogenesis were targeted studied. As a result of operation the conclusions are made: the solderings have typical organization not dependent on the mechanism of damage, adhesiogenesis is a step process, the probability of development of solderings depends on mesotelisation speed of peritoneal defect and fibrinolytic activity of peritoneum. The adhesiogenesis is simultaneously both protective and pathological phenomenon, can not be considered up to the extremity investigated and requires further researches.
One of the major problems of general surgery is the problem of postoperative adhesions of the abdominal cavity (SPBP) and severe, often life-threatening patient adhesive complications [2, 3, 4, 10]. The formation of postoperative adhesions of the connective serous cavities is a frequent occurrence after surgical procedures and is associated with adhesion of wound surfaces, prolapse of the peritoneal exudate of fibrin to further his organization in the connective tissue [6, 6, 8, 9, 11, 12]. This process is a typical reaction to the damage to the replacement of the defect of connective tissue, however, some patients develop abdominal adhesions slightly, while others already in the early postoperative period may lead to intestinal obstruction with a serious prognosis [1, 3, 4, 6, 8, 12]. Thus, biologically expedient response of the body, aimed at the localization of the pathologic process of the abdominal cavity (the demarcation of the pathological focus, revaskulya ization ischemic area, etc.) often becomes the cause of the disease, which can lead to severe complications such as adhesive ileus, and lack of a unified concept of etiology and pathogenesis, prevention and treatment of disease underlines the relevance of the problem.
The aim of our study was focused to study certain aspects of the pathogenesis of postoperative SPBP, which further help to substantiate the developed by us ways to prevent adhesions.
The experiments were performed on white male rats of Wistar, weighing 120-150, under ether anesthesia in aseptic conditions and median laparotomy was performed and the peritoneum exposed to various damaging effects on nature. Animals were removed from the experiment after 12 hours, 1, 3, 7 and 14 days. By opening the abdominal cavity of the severity of adhesions was evaluated visually (the prevalence of the process, flatulence, deformation of adhesions, the presence of effusion in the abdominal cavity, etc.) and using the semantic differential (on a scale with allowance for the significance of each symptom) [7 ]. Abdominal organs involved in the adhesive process, individual spikes were extracted and subjected to histological examination by standard methods.
After 12 hours of opening the abdominal cavity were reactive symptoms (hyperemia of internal organs, etc.). On day 1 was observed acute peritonitis (abdominal effusion wore serosanguineous nature, the volume amounted to 0,5-1,6 ml in different series). On the third day in a small amount of abdominal fluid, peritoneal damaged areas are covered with generic viagra fibrin, sometimes glued together. At the 7 th day of exudate in the abdominal cavity was absent, there were loose viscero-visceral and vistseroparietalnye spikes, which are well sever blunt. In 14 days adhesions were more dense consistency, with their stupid division traumatized soldered bodies.
Histological examination of biopsy material, for day 1 there was violation of the integrity of mesothelial cover in place of injury, the defect is covered by peritoneum peritoneal exudate cells (macrophages, lymphocytes, etc.), red blood cells, fibrin strands. Around the defect was noted hyperemia of the capillaries and microvascular, interstitial edema, lymphocytic infiltration of him. Mesothelial cells in the defect had a cubic shape. On the third day was determined by closing the wound surface mesothelial cells of elongated shape. By 1-2-week histostructure peritoneum in the areas of trauma was not different from intact, only in the connective tissue were based on areas of fibrosis.
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