Possibilities of regulating the reaction of tissues of the implantation area with pyrimidine preparations after prosthetic repair of the hernia ring in the experiment

Purpose of the study. Study of the possibilities of pharmacological regulation of local and systemic inflammatory response, stimulation of reparative regeneration in prosthetic repair of abdominal wall hernias.

Materials and methods. The experiment was carried out on 92 rats of both sexes of a pure line, divided into 4 groups. Group I (control) received only 1 ml of 0.9 % sodium chloride solution. Group II – hydroxyethyldimethyldihydropyrimidine 21 mg/day. Group III – potassium orotate 10.5 mg/day. Group IV – methyluracil 14 mg/day. Under anesthesia a mesh implant 4 × 2 cm was placed in the layer between the hypodermis and the superficial fascia. Animals were withdrawn from the experiment on days 5 (n = 52) and 14 days (n = 40). The site of implantation for histomorphometric studies captured the dermis, hypodermis, implant layer, fascia, and muscle. The preparation and staining of the preparations were carried out with hematoxylin-eosin and by Mallory.

Results. 1. On the 5th day after the operation group II (hydroxyethyldimethyldihydropyrimidine) was characterized by pronounced neovasculogenesis (p = 0.002, U-test) and more active processes of formation and maturation of connective tissue (p = 0.024, U-test) with a low immune response to a foreign body (p = 0.044, U- test). III (potassium orotate) and IV groups (methyluracil) were characterized by a pronounced decrease in the inflammatory response with a simultaneous increase in tissue edema (p < 0.001, U-test), slowing down the formation and maturation of connective tissue (p = 0.016, U-test). 2. On the 14^th day after the operation, group II (hydroxyethyldimethyldihydropyrimidine) was characterized an increase in the area of neovasculogenesis by 208.0 % (p < 0.001, U -criterion), a decrease in the volume of fluid accumulations by 63.4 % (p < 0.001, U-criterion), an increase in the processes of formation and maturation of connective tissue, mainly due to an increase in the number of fibrocytes by 333.3 % (p < 0.001, U-criterion). The parameters of the immune response to a foreign body had significant differences (p < 0.001, U-test).

Conclusion. The use of potassium orotate and methyluracil reduces the inflammatory response in the tissues of the implantation area, however, it is associated with the appearance of liquid components and with a decrease in the formation of connective tissue cells. The use of hydroxyethyldimethyldihydropyrimidine is devoid of the above disadvantages, it is characterized by the predominance of regeneration and neovasculogenesis processes, which allows it to be used as a pharmacological support drug for prosthetic hernioplasty.

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