Science and Innovations in MedicineScience and Innovations in MedicineНаука и инновации в медицине2500-13882618-754XFSBEI of Higher Education SamSMU of Ministry of Health of the Russian Federation69577910.35693/SIM695779SurgeryХирургияReview ArticleMolecular and cellular aspects of the pathogenesis of incisional herniasМолекулярные и клеточные аспекты патогенеза послеоперационных вентральных грыжhttps://orcid.org/0000-0003-4832-1682GalimovOleg V.ГалимовО. В.
Russian Federation

MD, Dr. Sci. (Medicine), Professor, Head of the Department of Surgical Diseases, Medical Faculty

д-р мед. наук, профессор, заведующий кафедрой хирургических болезней лечебного факультета

galimovov@mail.ruhttps://orcid.org/0000-0002-1880-0968KhanovVladislav O.ХановВ. О.
Russian Federation

MD, Dr. Sci. (Medicine), Professor of the Department of Surgical Diseases, Medical Faculty

д-р мед. наук, профессор кафедры хирургических болезней лечебного факультета

khanovv@mail.ruhttps://orcid.org/0000-0002-4160-2820BakeevMarat R.БакеевМарат Радикович
Russian Federation

Resident of the Department of Surgical Diseases, Medical Faculty

клинический ординатор кафедры хирургических болезней лечебного факультета

m.r.bakeev@bk.ruBashkir State Medical UniversityФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава России030120261902202611169760311202530112025Copyright ©; 2026, Galimov O.V., Khanov V.O., Bakeev M.R.Copyright ©; 2026, Галимов О.В., Ханов В.О., Бакеев М.Р.2026Galimov O.V., Khanov V.O., Bakeev M.R.Галимов О.В., Ханов В.О., Бакеев М.Р.https://creativecommons.org/licenses/by/4.0https://innoscience.ru/2500-1388/article/view/695779

The incisional hernias are one of the most common surgical pathologies worldwide. The achievements of medical science in recent decades have significantly improved the results of treatment of this disease, due to the justification and implementation of various methods of hernioplasty with implantation of synthetic endoprostheses. At the same time, the incidence rate of incisional hernias remains fairly high. For several years, research has been conducted to study the molecular and cellular mechanisms of incisional hernias formation. The key issue in the problem of tissue repair disorders after laparotomy is to understand the processes of extracellular matrix organization and fibroblast activation. The extracellular matrix appears to be a unique environment that promotes the proper structuring of collagen fibers, the acquisition of postoperative scar strength and timely wound cavity contraction. The regulation of extracellular matrix homeostasis depends on many factors that affect the timing and usefulness of tissue repair after surgical trauma. The main regenerative potential consists of populations of fibroblasts responsible for the synthesis and degradation of collagen. Extracellular matrix and fibroblasts have a multifactorial effect on wound repair and imbalance of their interaction can contribute to the formation of incisional hernias. Molecular compounds synthesized by fibroblasts, which include matrix metalloproteinases, matrix metalloproteinase inhibitors, as well as actin and collagen proteins, play an important role both in the healing of surgical wounds and in the formation of hernias. Identification of critical points in the pathogenesis of incisional hernias at the molecular and cellular levels will make it possible to predict and prevent their formation. This opens up new opportunities for precision stratification of patients before abdominal wall hernia repair and the choice of personalized surgical tactics.

Послеоперационные вентральные грыжи являются одними из самых распространенных хирургических патологий во всем мире. Достижения медицинской науки за последние десятилетия позволили значительно улучшить результаты лечения данного заболевания вследствие обоснования и внедрения различных способов герниопластик с имплантацией синтетических эндопротезов. В то же время частота возникновения послеоперационных вентральных грыж остается на достаточно высоком уровне. На протяжении нескольких лет проводятся исследования, направленные на изучение молекулярных и клеточных механизмов формирования послеоперационных грыж. Ключевым вопросом в проблеме нарушения репарации тканей после лапаротомий является понимание процессов организации внеклеточного матрикса и активизации фибробластов. Внеклеточный матрикс предстает той уникальной средой, способствующей правильной структуризации коллагеновых волокон, приобретению прочности послеоперационного рубца и своевременной контракции раневой полости. Регуляция гомеостаза внеклеточного матрикса находится в зависимости от многих факторов, влияющих на сроки и полноценность репарации тканей после операционной травмы. Основной регенераторный потенциал составляют популяции фибробластов, ответственных за синтез и деградацию коллагена. Внеклеточный матрикс и фибробласты оказывают многофакторное влияние на репарацию раны, и нарушения баланса их взаимодействия может способствовать формированию послеоперационных вентральных грыж. Синтезируемые фибробластами молекулярные соединения, к которым относятся матричные металлопротеиназы, тканевые ингибиторы металлопротеиназ, а также актиновые и коллагеновые белки, играют важную роль как в заживлении операционной раны, так и в формировании грыж. Определение критических точек патогенеза послеоперационных вентральных грыж на молекулярном и клеточном уровнях позволит прогнозировать и профилактировать их образование. При этом открываются новые возможности для прецизионной стратификации пациентов перед оперативным лечением грыж и выбора персонифицированной хирургической тактики.

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