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Complex hernia

Jad Chamieh, Wen Hui Tan, Ricardo Ramirez, Eden Nohra, Chukwuma Apakama, William Symons
BACKGROUND: Synthetic meshes have been used with varying rates of success in a contaminated setting, although their use is not widely accepted because of concerns for infection. A biologic mesh (BM) is assumed to be more resistant to infection than a synthetic mesh; however, sparse clinical data support this theory. The hypothesis for this study: Uncoated polypropylene synthetic mesh (USM) can be used to obtain a durable repair in the setting of a contaminated abdominal wall reconstruction (AWR) in a single-stage procedure with comparable infectious outcomes to a biologic mesh repair...
October 18, 2016: Surgical Infections
Florian Geisler, Harald Gerhardus, Katrin Carberry, Wayne Davis, Erik Jorgensen, Christine Richardson, Olaf Bossinger, Rudolf E Leube
Intermediate filaments are major cytoskeletal components whose assembly into complex networks and isotype-specific functions are still largely unknown. Caenorhabditis elegans provides an excellent model system to study intermediate filament organization and function in vivo Its intestinal intermediate filaments localize exclusively to the endotube, a circumferential sheet just below the actin-based terminal web. A genetic screen for defects in the organization of intermediate filaments identified a mutation in the catalytic domain of the MAP kinase 7 ortholog sma-5(kc1) In sma-5(kc1) mutants pockets of lumen penetrate the cytoplasm of the intestinal cells...
October 12, 2016: Molecular Biology of the Cell
Carla Cunha, Catarina R Almeida, Maria Inês Almeida, Andreia M Silva, Maria Molinos, Sofia Lamas, Catarina L Pereira, Graciosa Q Teixeira, António T Monteiro, Susana G Santos, Raquel M Gonçalves, Mário A Barbosa
: : Cell therapies for intervertebral disc (IVD) regeneration presently rely on transplantation of IVD cells or stem cells directly to the lesion site. Still, the harsh IVD environment, with low irrigation and high mechanical stress, challenges cell administration and survival. In this study, we addressed systemic transplantation of allogeneic bone marrow mesenchymal stem cells (MSCs) intravenously into a rat IVD lesion model, exploring tissue regeneration via cell signaling to the lesion site...
October 11, 2016: Stem Cells Translational Medicine
Richard W Siy, Rachel E Pferdehirt, Shayan A Izaddoost
INTRODUCTION: The use of biologic mesh where native tissue deficiencies limit reconstructive options has been well documented in the adult population, with increasing use to address the special requirements of complex abdominal wall reconstruction. There is, however, little documented evidence as to the safety and efficacy of these products in the pediatric population. METHODS: This retrospective case series details 5 pediatric cases of complicated abdominal hernia repair with Strattice®, a non-crosslinked porcine acellular dermal matrix...
September 23, 2016: Journal of Pediatric Surgery
Margarita V Revzin, Devrim Ersahin, Gary M Israel, Jonathan D Kirsch, Mahan Mathur, Jamal Bokhari, Leslie M Scoutt
Ultrasonography (US) has a fundamental role in the initial examination of patients who present with symptoms indicating abnormalities of the inguinal canal (IC), an area known for its complex anatomy. A thorough understanding of the embryologic and imaging characteristics of the contents of the IC is essential for any general radiologist. Moreover, an awareness of the various pathologic conditions that can affect IC structures is crucial to preventing misdiagnoses and ensuring optimal patient care. Early detection of IC abnormalities can reduce the risk of morbidity and mortality and facilitate proper treatment...
October 7, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
John W Scott, Joaquim M Havens, Lindsey L Wolf, Cheryl K Zogg, John A Rose, Ali Salim, Adil H Haider
BACKGROUND: The Affordable Care Act has the potential to significantly affect access to care for previously uninsured patients in need of emergency general surgical care. Our objective was to determine the relationship between insurance status and disease complexity at presentation among a national sample of emergency general surgical patients. METHODS: Data from the National Emergency Department Sample from 2006-2009 were queried to identify all patients aged 18-64 years old admitted through the emergency department with a primary diagnosis of appendicitis, diverticulitis, inguinal hernia, or bowel obstruction...
October 3, 2016: Surgery
Nicholas E Bruns, Ian C Glenn, Neil L McNinch, Kelly Arps, Todd A Ponsky, Avraham Schlager
PURPOSE: Although recurrence remains one of the most feared complications following congenital diaphragmatic hernia (CDH) repair, there are minimal data on the optimal surgical approach to these complex situations. The purpose of this study was to survey the international pediatric surgery community to ascertain practice patterns for both minimally invasive (MIS) and open approaches for recurrent CDH. MATERIALS AND METHODS: A survey was e-mailed to members of an online community of pediatric surgeons...
October 5, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Emily M Hatch, Martin W Hetzer
Repeated rounds of nuclear envelope (NE) rupture and repair have been observed in laminopathy and cancer cells and result in intermittent loss of nucleus compartmentalization. Currently, the causes of NE rupture are unclear. Here, we show that NE rupture in cancer cells relies on the assembly of contractile actin bundles that interact with the nucleus via the linker of nucleoskeleton and cytoskeleton (LINC) complex. We found that the loss of actin bundles or the LINC complex did not rescue nuclear lamina defects, a previously identified determinant of nuclear membrane stability, but did decrease the number and size of chromatin hernias...
October 10, 2016: Journal of Cell Biology
Salvatore Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: Prior abdominal wall radiotherapy (XRT) adversely affects wound healing, but data are limited on how prior XRT may affect abdominal wall reconstruction (AWR) outcomes. The purpose of this study was to determine whether prior abdominal wall radiotherapy is associated with a higher incidence of complications following AWR for a hernia or oncologic resection defect. METHODS: We performed a retrospective study of consecutive patients who underwent complex AWR using acellular dermal matrix (ADM) at a single center...
September 30, 2016: Annals of Surgical Oncology
Takaki Emura, Hiroshi Ohta, Noboru Oyachi, Takeyuki Suzuki
INTRODUCTION: Laparoscopic percutaneous extraperitoneal closure (LPEC) in boys is more complex than in girls, because the vas deferens and testicular vessels must be separated from the peritoneum. We therefore developed a needle-shaped surgical instrument that enables blunt separation. Here, we report the effectiveness of this new device. SURGICAL TECHNIQUE: The new device is a ligature carrier consisting of (1) an inner tube (19-G blunt needle) through which slides a rod with a loop wire at its tip that can catch and release suture materials and (2) an outer tube (17-G needle) with a cutting edge...
September 28, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Rodolfo J Oviedo, Jarrod C Robertson, Sharifah Alrajhi
BACKGROUND AND OBJECTIVES: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. METHODS: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
September 14, 2016: Operative Orthopädie und Traumatologie
A Willms, S Schaaf, R Schwab, I Richardsen, D Bieler, B Wagner, C Güsgen
PURPOSE: The open abdomen has become a standard technique in the management of critically ill patients undergoing surgery for severe intra-abdominal conditions. Negative pressure and mesh-mediated fascial traction are commonly used and achieve low fistula rates and high fascial closure rates. In this study, long-term results of a standardised treatment approach are presented. METHODS: Fifty-five patients who underwent OA management for different indications at our institution from 2006 to 2013 were enrolled...
September 6, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Kristen E Elstner, John W Read, Omar Rodriguez-Acevedo, Kevin Ho-Shon, John Magnussen, Nabeel Ibrahim
BACKGROUND: A rarely used technique for enabling closure of large ventral hernias with loss of domain is preoperative progressive pneumoperitoneum (PPP), which uses intermittent insufflation to gradually stretch the contracted abdominal wall muscles, increasing the capacity of the abdominal cavity. This allows the re-introduction of herniated viscera into the abdominal cavity and assists in closure of giant hernias which may otherwise be considered inoperable. METHODS: This was a prospective study assessing 16 patients between 2013 and 2015 with multi-recurrent ventral hernia...
August 29, 2016: Surgical Endoscopy
Caitlin W Hicks, Katherine E Poruk, Pablo A Baltodano, Kevin C Soares, Said C Azoury, Carisa M Cooney, Peter Cornell, Frederic E Eckhauser
BACKGROUND: Sandwich ventral hernia repair (SVHR) may reduce ventral hernia recurrence rates, although with an increased risk of surgical site occurrences (SSOs) and surgical site infections (SSIs). Previously, we found that a modified negative pressure wound therapy (hybrid vacuum-assisted closure [HVAC]) system reduced SSOs and SSIs after ventral hernia repair. We aimed to describe our outcomes after SVHR paired with HVAC closure. METHODS: We conducted a 4-y retrospective review of all complex SVHRs (biologic mesh underlay and synthetic mesh overlay) with HVAC closure performed at our institution by a single surgeon...
August 2016: Journal of Surgical Research
A K Wang, X L Kang
Craniosynostosis(CS), the premature fusion of cranial sutures leading to an abnormal shape and precocious maturity of skull, is classified into Non-syndromic Craniosynostosis (NSC) and Syndromic Craniosynostoses(SC).NCS only has different abnormality of skull according to which cranial suture is involved while extra malformation of midface and limbs present in SCS. Common SCS contains Crouzon Syndrome, Apert Syndrome, Pfeiffer Sydrome, and etc. The clinical manifestation of CS includes malformation of skull, intracranial hypertension, brain hernia, developmental disorder of cerebral function, strabismus, and etc, while SCS has more complex manifestation...
August 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Sharmistha Rudra, Obinna O Adibe, William F Malcolm, P Brian Smith, C Michael Cotten, Rachel G Greenberg
BACKGROUND: Gastrostomy tube (G-tube) placement is a common intervention for newborns with severe feeding difficulties. Infants with congenital diaphragmatic hernia (CDH) are at high risk for feeding problems. Prevalence of G-tube placement and consequent nutritional outcomes of infants with CDH and G-tubes has not been described. AIMS: Determine factors associated with G-tube placement and growth in infants with congenital diaphragmatic hernia. STUDY DESIGN: Retrospective cohort study of infants with CDH to evaluate the association of G-tube placement with risk factors using logistic regression...
August 22, 2016: Early Human Development
Steven T Lanier, Jennifer E Fligor, Kyle R Miller, Gregory A Dumanian
BACKGROUND: Our objective was to determine outcomes for complex ventral hernia repairs in a large cohort of patients utilizing an operative construct employing retrorectus placement of a narrow, macroporous polypropylene mesh with up to 45 suture fixation points for force distribution. No consensus exists on the optimal technique for repair of complex ventral hernias. Current trends emphasize large meshes with wide overlaps and minimal suture fixation, though reported complications and recurrence remain problematic...
August 18, 2016: Surgery
Boris Groisman, Juan Gili, Lucas Giménez, Fernando Poletta, María Paz Bidondo, Pablo Barbero, Rosa Liascovich, Jorge López-Camelo
Geographical clusters are defined as the occurrence of an unusual number of cases higher than expected in a given geographical area in a certain period of time. The aim of this study was to identify potential geographical clusters of specific selected congenital anomalies (CA) in Argentina. The cases were ascertained from 703,325 births, examined in 133 maternity hospitals in the 24 provinces of Argentina. We used the spatial scan statistic to determine areas of Argentina which had statistically significant elevations of prevalence...
August 19, 2016: Journal of Community Genetics
Andreas Kuthe
INTRODUCTION: Seroma formation is one of the most prevalent complications after liposuction, abdominoplasty, mastectomy or hernia repair. They can disappear without treatment, but also may persist and require complex therapy. This report describes how 4DryField(®) PH polysaccharide powder successfully was applied for chronic seroma therapy. PRESENTATION OF THE CASE: An 80year old male patient presented with a persistent seroma (1000cm(3) volume) resulting from liposuction about 15 years ago...
2016: International Journal of Surgery Case Reports
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