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Yuri novitsky

Arnab Majumder, Heidi J Miller, Parita Patel, Yuhsin V Wu, Heidi L Elliott, Yuri W Novitsky
BACKGROUND: Despite patient risk factors such as diabetes and obesity, contamination during surgery remains a significant cause of infections and subsequent wound morbidity. Pressurized pulse lavage (PPL) has been utilized as a method to reduce bacterial bioburden with promising results in many fields. Although existing methods of lavage have been utilized during abdominal operations, no studies have examined the use of PPL during complex hernia repair. METHODS: Patients undergoing abdominal wall reconstruction (AWR) in clean-contaminated or contaminated fields with antibiotic PPL, from January 2012 to May 2013, were prospectively evaluated...
October 31, 2016: Surgical Endoscopy
Antonio Espinosa-de-Los-Monteros, H├ęctor Avendano-Peza, Yuri W Novitsky
Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction...
September 2016: Plastic and Reconstructive Surgery. Global Open
Arnab Majumder, Joshua S Winder, Yuxiang Wen, Eric M Pauli, Igor Belyansky, Yuri W Novitsky
BACKGROUND: Contaminated operative fields pose significant challenges for surgeons performing ventral hernia repair. Although biologic meshes have been utilized increasingly in these fields, recent evidence suggests that synthetic meshes represent a viable option. We analyzed the outcomes of biologic and synthetic mesh utilized in patients undergoing major ventral hernia repair in clean-contaminated/contaminated fields. METHODS: We conducted a multicenter, retrospective review of patients undergoing open ventral hernia repair in clean-contaminated/contaminated fields using biologic or synthetic mesh...
October 2016: Surgery
Arnab Majumder, Jeffrey R Scott, Yuri W Novitsky
Background Despite meticulous aseptic technique and systemic antibiotics, bacterial colonization of mesh remains a critical issue in hernia repair. A novel minocycline/rifampin tyrosine-coated, noncrosslinked porcine acellular dermal matrix (XenMatrix AB) was developed to protect the device from microbial colonization for up to 7 days. The objective of this study was to evaluate the in vitro and in vivo antimicrobial efficacy of this device against clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli...
October 2016: Surgical Innovation
Arnab Majumder, Clayton C Petro, Lijia Liu, Mojtaba Fayezizadeh, Yuri W Novitsky
BACKGROUND: Indications regarding hernia repair after removal of previously infected prostheses remain unclear. Patients may receive staged primary repair or single-stage reconstructions, neither of which may be ideal. Although animal models have simulated contamination by direct inoculation of implants with bacteria, there remains a paucity of literature, which simulates a field following mesh infection and removal. We aimed to develop a murine model to mimic this complex scenario to allow for further testing of various implants...
June 28, 2016: Surgical Endoscopy
Mojtaba Fayezizadeh, Arnab Majumder, Igor Belyansky, Yuri W Novitsky
BACKGROUND: Optimal mesh reinforcement and operative technique for major abdominal wall reconstructions (AWR) remain debatable. Posterior component separation via transversus abdominis release (TAR) allows for wide sublay mesh reinforcement with durable reconstruction, and has been gaining popularity in recent years. Although biologic mesh has been associated with mixed results, outcomes of AWR with bioprosthetics have not been well elucidated to date. We evaluated our outcomes of TAR reconstructions with retromuscular porcine biologic mesh reinforcement...
September 2016: Journal of the American College of Surgeons
Jeremy Wang, Arnab Majumder, Mojtaba Fayezizadeh, Cory N Criss, Yuri W Novitsky
Ventral hernia repair (VHR) in patients with inflammatory bowel disease (IBD) presents unique surgical challenges including impaired wound healing, concomitant intestinal operations, along with likely future abdominal surgeries. Appropriate techniques and mesh choices in these patients remain under active debate. Herein we report our experience with using a retromuscular approach for major VHR in a consecutive cohort of IBD patients. We identified all patients with IBD undergoing open VHR with retrorectus mesh placement between 2007 and 2013 in our prospectively maintained database...
June 2016: American Surgeon
Mojtaba Fayezizadeh, Arnab Majumder, Ruel Neupane, Heidi L Elliott, Yuri W Novitsky
BACKGROUND: Transversus abdominis plane block (TAPb) is an analgesic adjunct used for abdominal surgical procedures. Liposomal bupivacaine (LB) demonstrates prolonged analgesic effects, up to 72 hours. We evaluated the analgesic efficacy of TAPb using LB for patients undergoing open abdominal wall reconstruction (AWR). METHODS: Fifty patients undergoing AWR with TAPb using LB (TAP-group) were compared with a matched historical cohort undergoing AWR without TAPb (control group)...
September 2016: American Journal of Surgery
Arnab Majumder, Mojtaba Fayezizadeh, William W Hope, Yuri W Novitsky
BACKGROUND: Existing permanent helical coil fasteners, although commonly employed for mesh fixation during laparoscopic hernia repair, are associated with peritoneal tissue attachment formation and resultant visceral complications. We evaluated attachment formation, fastener engagement, and mesh/tissue integration associated with laparoscopic fixation using a novel permanent capped helical coil fastener (HC-Capped) compared to permanent non-capped helical coil fasteners (HC-Non-Capped) in a porcine model...
December 2016: Surgical Endoscopy
Arnab Majumder, Mojtaba Fayezizadeh, Ruel Neupane, Heidi L Elliott, Yuri W Novitsky
BACKGROUND: Use of Enhanced Recovery After Surgery (ERAS) pathways have evidenced improved outcomes in several surgical specialties. The effectiveness of ERAS pathways specific to hernia surgery, however, has not yet been investigated. We hypothesized that our ERAS pathway would accelerate functional recovery and shorten hospitalization in patients undergoing open ventral hernia repair (VHR). STUDY DESIGN: Consecutive patients undergoing open major VHR using transversus abdominis release and sublay synthetic mesh placement, with use of our ERAS pathway, were compared with a historical cohort before ERAS implementation...
June 2016: Journal of the American College of Surgeons
Yuri W Novitsky, Mojtaba Fayezizadeh, Arnab Majumder, Ruel Neupane, Heidi L Elliott, Sean B Orenstein
OBJECTIVE: To evaluate the safety and efficacy of transversus abdominis muscle release (TAR) with retrorectus synthetic mesh reinforcement in a large series of complex hernia patients. BACKGROUND: Posterior component separation via TAR during abdominal wall reconstruction (AWR) continues to gain popularity. Although our early experience with TAR has been promising, long-term outcomes have not been reported. METHODS: From December 2006 to December 2014, consecutive patients undergoing open AWR utilizing TAR were identified in our prospectively maintained database and reviewed retrospectively...
August 2016: Annals of Surgery
Arnab Majumder, Yue Gao, Emanuel E Sadava, James M Anderson, Yuri W Novitsky
BACKGROUND: While mesh reinforcement is recognized as the optimal strategy for many hernia repairs, there remains debate on the optimal position for deployment and characteristics that lead to improved biocompatibility. Coatings are an avenue by which integration may be improved. Our aim was to evaluate tissue integration between uncoated, fibroblast- and mesenchymal stem cell-coated meshes placed as subcutaneous onlay (ON) or intraperitoneal underlay (UN). METHODS: Three commonly used biologic and synthetic hernia meshes were tested including Parietex, TIGR and Strattice...
October 2016: Surgical Endoscopy
Jeffrey A Blatnik, David M Krpata, Yuri W Novitsky
No abstract text is available yet for this article.
April 2016: JAMA Surgery
Clayton C Petro, Siavash Raigani, Mojtaba Fayezizadeh, James R Rowbottom, John C Klick, Ajita S Prabhu, Yuri W Novitsky, Michael J Rosen
No abstract text is available yet for this article.
April 2016: Plastic and Reconstructive Surgery
Arnab Majumder, Ruel Neupane, Yuri W Novitsky
Mesh bacterial colonization/infection remains a critical issue in complex ventral hernia repair. Despite the recent emergence of biologic meshes, current strategies to prevent and treat mesh infection are largely ineffective, often leading to device failure and subsequent explantation along with the associated costs and effect on patient welfare. Unacceptably high rates of morbidity and hernia recurrence following mesh infection highlight the need for innovation in the area of hernia repair for the complex patient...
November 2015: Surgical Technology International
Clayton C Petro, Natasza M Posielski, Siavash Raigani, Cory N Criss, Sean B Orenstein, Yuri W Novitsky
BACKGROUND: Retrorectus repairs (RR) of abdominal wall hernias are growing in popularity, yet wound morbidity and predictors in this context have been characterized poorly. Models aimed at predicting wound morbidity typically do not control for technique and/or location of mesh. Our aim was to describe wound morbidity and risk factors specifically in the context of RR hernia repair. Our hypothesis was that the incidence of wound morbidity with mesh sublay would be less than predicted by a model that does not control for mesh position...
December 2015: Surgery
Clayton C Petro, Siavash Raigani, Mojtaba Fayezizadeh, James R Rowbottom, John C Klick, Ajita S Prabhu, Yuri W Novitsky, Michael J Rosen
BACKGROUND: Repair of hernias with loss of domain can lead to elevated intraabdominal pressure. The authors aimed to characterize the effects of elective hernia repair on intraabdominal pressure, as well as its predictors and association with negative outcomes. METHODS: Patients undergoing elective hernia repair requiring myofascial release had intraabdominal and pulmonary plateau pressures measured preoperatively, postoperatively, and on the morning of the first postoperative day...
October 2015: Plastic and Reconstructive Surgery
Clayton C Petro, John J Como, Sydney Yee, Ajita S Prabhu, Yuri W Novitsky, Michael J Rosen
BACKGROUND: The best reconstructive approach for large fascial defects precipitated from a previous open abdomen has not been elucidated to date. We use a posterior component separation with transversus abdominis muscle release (TAR) in this scenario. METHODS: Patients with a history of an open abdomen who ultimately underwent complex hernia repair with TAR from 2010 to 2013 at Case Medical Center were identified in our prospective database and analyzed. RESULTS: Of 34 patients (mean [SD] age, 54 [11...
February 2015: Journal of Trauma and Acute Care Surgery
Clayton C Petro, Sean B Orenstein, Cory N Criss, Edmund Q Sanchez, Michael J Rosen, Kenneth J Woodside, Yuri W Novitsky
BACKGROUND: Incisional hernias in kidney transplant recipients (KTRs) can be complex because of adjacent bony structures, proximity of the allograft/transplant ureter, and context of immunosuppression. We hypothesized that our novel posterior component separation with transversus abdominis muscle release (TAR) and retromuscular mesh reinforcement offers a safe and durable repair. METHODS: KTRs with incisional hernias repaired using the aforementioned technique were identified within our prospective database (2007 to 2013) and analyzed...
August 2015: American Journal of Surgery
Ean R Saberski, Sean B Orenstein, Dale Matheson, Yuri W Novitsky
Medical curricula are continually evolving and increasing clinical relevance. Gross anatomy educators have tested innovations to improve the clinical potency of anatomic dissection and found that clinical correlations are an effective method to accomplish this goal. Recently, surgical educators defined a role for laparoscopy in teaching anatomy. We aimed to expand this role by using surgical educators to create clinical correlates between gross anatomy and clinical surgery. We held supplements to traditional anatomy open dissection for medical students, including viewing prerecorded operative footage and live laparoscopic dissection performed on cadavers...
January 2015: American Surgeon
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