http://www.revmaterialeplastice.ro MATERIALE PLASTICE ♦54♦No. 3 ♦2017 510 A comparative Histologic and Immunohistochemistry Evaluation Between Normal Aponeurotic Tissue, Fibrotic Aponeurotic Scars and Polypropylene Embedded Aponeurotic Scars RADU CHICEA, DAN BRATU*, ANCA LUCIA CHICEA, ALIN MIHETIU, VLAD PRELUCA, CRISTIAN TANTAR, MIHAI SAVA Lucian Blaga University of Sibiu, Faculty of Medicine, 2A Lucian Blaga Str., 550169, Sibiu, Romania Synthetic polypropylene materials are increasingly being used in surgery to repair parietal defects in perineal floor curing surgery, in genital prolapse and stress urinary incontinence. The tissue response to contact with these materials varies, and the inflammatory tissue response may be a prognostic marker of success in surgical interventions that involve contact between tissues and polypropylene materials. Keywords: aponeurotic tissue, scars, inflammatory reaction, polypropylene Used since 1950 to replace parietal defects initially only for complex inguinal hernia, by improving their characteristics, polypropylene materials have been introduced in the treatment of surgical gynecological and urological pathology. The rate of relapse after use of prosthetic materials is significantly reduced, but there is a significant percentage of complications of which the most common are: local bleeding with hematoma formation, urinary tract and bladder trauma, erosions, intestinal perforations, urinary tract infections, vaginal expulsion, etc. [1-3]. The current trend is to find and produce ways to limit the inflammatory response and to increase the polypropylene tissue integration rate. This would result in a significant decrease in local graft complications, complications that may be erosions, infections, excessive scarring, all of which impinging on a good outcome, especially through the risk of developing dyspareunia. A material is considered as biocompatible when it does not harm nor create toxic reactions or systemic side effects [4]. In fact, no mesh has demonstrated a biocompatibility and integration rate in host tissues at optimal level, and in literature there are few studies that determine which of the multiple variants is the best method applicable for vaginal surgery. Tissue responsiveness to mesh causes a cascade of healing, events involving clotting, inflammation, angiogenesis, fibroplasty, cellular matrix formation and cell and tissue contraction. Biocompatibility is determined by the intensity of the foreign body reaction, and is expressed by the ability of the mesh and host tissue to resolve the tissue damage due to the implantation process. Mesh-like features such as pore size, chemical composition, filament structure, amount of implanted material and biodegradability are characteristics that influence the processes of angiogenesis, inflammation, tissue neoformation, and may affect the healing process. Inflammatory cells mobilized in the allograft implant site produce signaling molecules, molecules that will influence the tissue response to biomaterial [5]. * e m a il: bratudan19@yahoo.com; Phone: 0745771626 All authors had equal contributionm The molecular response mechanisms of foreign body response body are poorly understood. Macrophages that come in contact with the mesh surface are activated in an attempt to phagocytose the allograft fibers. They will merge and form FBGCs – foreign body giant cells. The sequential secretion of cytokines, degrading enzymes and intermediate oxidative reactions of macrophages and FBGCs direct the inflammatory response and healing by influencing the behavior of other cell types like neutrophils (polymorphonuclear leukocytes [PMNs]), lymphocytes, fibroblasts and monocytes [6]. Recent laboratory studies highlight an in vivo gene expression involved in angiogenesis and modeling of the extracellular matrix after fitting prostheses used for anterolateral abdominal parietal defects including polypropylene, polyester, and polytetrafluoroethylene materials [7]. Experimental part The study included histological parts as follows: Healthy tissue - aponevrosis - histology base of the pathological anatomy section taken on different occasions for other indications. For the prosthetic material included in the aponeurosis, small fragments were taken during surgical interventions from patients who underwent recurrent surgical for recurrence or recovered material during initial correctional cure. Scar tissue – collected from surgical cures and reinterventions for different pathologies. All fragments of tissue and prosthetic material were collected with patients’ informed consent. We evaluated mesh biocompatibility by analyzing collagen density, fibroblast density, lymphocyte infiltrate and vascularization of a mesh embedded aponeurosis (a3), compared with a normal aponeurosis negative control (a2), and an aponeurotic fibrotic scar (a1) Histologic and immunohistochemistry processing Paraffin embedded sections were stained for collagen with the van Gieson method using standard protocols. IHC was performed for vimentin (fibroblasts and other mesenchymal cells) CD3, CD5 and CD20 (lymphocytes),