Stress-strain properties of aponeurotic suture in anterior abdominal wall after a midline laparotomy

Objective: method development for preventing postoperative ventral hernias based on experimental assessment of the stress-strain properties of aponeurosis in various types of a midline laparotomy. Materials and methods. We evaluated 42 fascia muscular aponeurotic complexes of the anterior abdominal wall. Based on the technique for dissecting the aponeurosis and its suturing, the complexes were divided into two groups (each containing 21 samples): Group 1 with a bypass of the umbilical ring on the left, and Group 2 with umbilical ring dissection. Results. Fascia aponeurotic complexes dissected and sutured through the umbilical ring (Group 2) had, on the average, higher values of mechanical characteristics. E.g., mean values of tensile stress (S), tensile stress at a maximum load (Smax), Young’s modulus (E), aponeurotic tensile strain (D), aponeurotic tensile strain at a maximum load (Dmax), and maximum load level (Load) were higher in Group 2 by 35.4; 39.8; 14.9; 34.6; 30.2 and 40.2 (%), respectively. Conclusion. We conducted the development, experimental application and evaluation of a novel method for preventing postoperative ventral hernias after a midline laparotomy based on the assessment of the stress-strain properties of aponeurosis.