Significance of the structure and metabolism of the extracellular matrix in the pathogenesis of abdominal hernias. Review

Ventral hernias remain one of the most frequent reason for scheduled and emergency surgeries. Despite the widespread use of various methods and technologies of hernias repair, including traditional non-invasive and laparoscopic methods popular in recent years, the problem of recurrent hernias remains relevant to this day. At the end of the last century, studies have shown that patients with inguinal hernias, compared with patients operated on for other intraabdominal reasons, have pronounced quantitative and qualitative changes in collagen proteins. This, in turn, led to increased interest in the exchange of connective tissue and the structure of the extracellular matrix in patients with hernia disease and other similar diseases, as well as the biology of wound healing and scar formation to this day. Significant number of experimental and clinical studies of the structure and function of the extracellular matrix in patients with hernia disease have been accumulated. The review is designed to reveal current understanding of relationships of metabolism of connective tissues and structure of extracellular matrix to pathogenesis of ventral hernias in order to identify key points, which will, in the future, develop a personalized approach to treatment of patients with these disorders.