Piatnochka V. Forecasting and prevention of complications in surgical treatment of patients with primary and postoperative ventral hernias under comorbid conditions

The thesis presents a theoretical generalization and a new solution to the problem of improving the results of surgical treatment of patients with primary and postoperative ventral hernias under conditions of comorbidity. It has been shown that unsatisfactory results of surgical treatment of ventral hernias are associated with a number of disadvantages: the choice of inadequate hernioplasty in a particular clinical situation, a malformation of the muscular aponeurotic layer of the anterior wall, especially in patients with postoperative ventricular hernias, concomitant syndrome of undifferentiated dysplasia connective tissue and obesity for hidden defects and weaknesses, wrong choice of type of mesh implant (“light” or “heavy” polypropylene mesh) and its size, incorrect type of suture material, and high-traumatic surgery. The advantages of “light” polypropylene mesh implantation in combination with a PRF membrane have been confirmed experimentally (morphologically, morphometrically, ultrastructurally) due to the shortest duration and severity of the exudative phase of inflammation in the implantation area, which in turn significantly reduces the number of local wound complications. All this allowed clinically testing the use of a combination of a “light” polypropylene mesh with a PRF membrane in the treatment of primary and postoperative ventral hernias, especially in the concomitant syndrome of undifferentiated connective tissue dysplasia and in patients with comorbidity. In addition, methods for fixing mesh implants have been improved, which has improved the reliability and safety of surgical intervention. The developed set of measures allowed to reliably lower the frequency of early local postoperative complications, the level of postoperative lethality and the number of postoperative relapses.