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. 2023 Feb;16(2):244-253.
doi: 10.25122/jml-2022-0200.

Distinctive characteristics of granulation tissue in laparotomy wounds with underlying oncological processes

Igor Kalynovych Morar  1 , Oleksandr Ivanovich Ivashchuk  1 , Yurii Yevhenovych Rohovyi  2 , Volodymyr Yuriyovych Bodiaka  1 , Aliona Andriivna Antoniv  3
Affiliations

Distinctive characteristics of granulation tissue in laparotomy wounds with underlying oncological processes

Igor Kalynovych Morar et al. J Med Life. 2023 Feb.

Abstract

This study aimed to investigate the effects of malignant neoplasms on the morphological characteristics of laparotomy wound granulation tissue in the muscular-aponeurotic layer. The study involved a sample of 34 deceased individuals who had undergone abdominal organ surgery. Biopsy samples were taken from the muscular-aponeurotic layer of the anterior abdominal wall and subjected to histological examination, including staining with hematoxylin and eosin and methylene blue/Chromotrope 2B using N.Z. Slinchenko's method. Descriptive methods and morphometry were used to evaluate pathomorphological changes. The results suggest that malignant neoplasms significantly impede and decelerate the maturation of laparotomy wound granulation tissue. Surgeries performed at the late stages of abdominal organ malignant neoplasms result in an uneven and slow maturation of the tissue, characterized by a higher prevalence of lymphoid cells, increased blood vessel volume, reduced optical density of stained collagen fibers, and pronounced chromotropophilia of collagen fibers. These distinct features should be considered to prevent postoperative eventration, a complication that is more likely to occur in this patient group. Clinicians should be aware of the possible consequences of malignant neoplasms on laparotomy wound granulation tissue, which may require additional measures to prevent postoperative complications in these patients.

Keywords: granulation tissue; laparotomy wound; oncological process.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Microscopic view of the laparotomy wound granulation tissue on the first day of the early postoperative period. Methylene blue/Chromotrope 2B staining according to N.Z. Slinchenko’s method. The image shows abundant fibrin (1), a low number of lymphocytes (2), and areas of hemorrhage (3). Magnification: (Ob) 20×, (Oc) 10×.
Figure 2
Figure 2
Microscopic view of laparotomy wound granulation tissue on the 3rd-4th day of the early postoperative period. Hematoxylin and eosin staining. The image shows an area of more mature granulation tissue (1) transitioning into an area of immature granulation tissue (2) in the muscular tissue layer (3). Magnification: (Ob) 20×, (Oc) 10×.
Figure 3
Figure 3
Microscopic view of the laparotomy wound granulation tissue on the 3-4th day of the early postoperative period. Methylene blue/Chromotrope 2B staining according to N.Z. Slinchenko’s method. The image shows the transition from young granulation tissue (1) to connective tissue (2) and marked chromotropophilia. Magnification: (Ob) 10×, (Oc) 10×.
Figure 4
Figure 4
Microscopic view of the laparotomy wound granulation tissue on the 2-3rd day of the early postoperative period. Immature granulation tissue with numerous lymphoid cells (1) and a small number of fibroblasts (2) is visible. Hematoxylin and eosin staining. Magnification: (Ob) 20×, (Oc) 10×.
Figure 5
Figure 5
Microscopic view of the laparotomy wound granulation tissue on the 2-3rd day of the early postoperative period. Methylene blue/Chromotrope 2B staining according to N.Z. Slinchenko’s method. The image shows a high number of lymphoid cells (1) and absence of formed collagen fibers. Magnification: (Ob) 10×, (Oc) 10×.
Figure 6
Figure 6
Microscopic view of the laparotomy wound granulation tissue on the 4-5th day of the early postoperative period. Hematoxylin and eosin staining shows uneven maturation of the young granulation tissue (1) with normal and elongated fibroblasts (2). Subtle muscle fibers are also visible (3). Magnification: (Ob) 20×, (Oc) 10×.
Figure 7
Figure 7
Microscopic view of the laparotomy wound granulation tissue on the 4-5th day of the early postoperative period. The image shows the area of fresh and mature granulation tissue with marked chromotropophilia. Methylene blue/Chromotrope 2B staining according to N.Z. Slinchenko’s method. Magnification: (Ob) 10×, (Oc) 10×.
Figure 8
Figure 8
Microscopic view of the laparotomy wound granulation tissue on the 2-3rd day of the early postoperative period in physical bodies of deceased individuals. Hematoxylin and eosin staining. The lymphoid cells and fibroblasts (1) are evenly distributed, indicating regular maturation of the granulation tissue. Blood vessels (2) are also visible. Magnification: (Ob) 20×, (Oc) 10×.
Figure 9
Figure 9
Microscopic view of the laparotomy wound granulation tissue on the 6-7th day of the early postoperative period in physical bodies of deceased individuals. Hematoxylin and eosin staining. The image shows a predominance of fibroblasts (1) and a low number of lymphoid cells, along with visible blood vessels (2). Magnification: (Ob) 20×, (Oc) 10×.
Figure 10
Figure 10
Microscopic view of laparotomy wound granulation tissue on days 6-7 of early postoperative period. The image shows intensively stained collagen fibers (1) and marked chromotropophilia, characteristic of later stages of tissue maturation. Stained with Methylene blue/Chromotrope 2B using N.Z. Slinchenko’s method. Magnification: (Ob) 10×, (Oc) 10×.
Figure 11
Figure 11
Microscopic view of the laparotomy wound granulation tissue on the 7th-8th day of the early postoperative period. Mature granulation tissue is visible, with fibroblasts (1) and collagen fibers (2) present and no chromotropophilia registered. Magnification: (Ob) 10×, (Oc) 10×.
See this image and copyright information in PMC

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