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"Abdominal wall closure"

H Hande Aydinli, Colin Peirce, Erman Aytac, Feza H Remzi
INTRODUCTION: Abdominal wound closure is a challenge in patients undergoing colorectal surgery with a complex history of multiple abdominopelvic operations. Loss of domain of the abdominal fascia because of prior laparotomies precludes the use of simple, everyday abdominal wound closure techniques. Furthermore, ongoing intra-abdominal sepsis, with or without a concurrent entero- or colocutaneous fistula, increases the risk of postoperative morbidity and mortality in this patient population...
April 2018: Diseases of the Colon and Rectum
Jang I Moon, Thomas D Schiano, Alyssa Burnham, Kwai Lam, Kishore R Iyer
BACKGROUND: The ideal donor in intestinal transplantation is generally considered to be 50 - 70% of recipient body weight. This may be due to concerns for "small for size" syndrome as seen in liver transplantation. We report our experience using smaller donors (donor-recipient weight ratio, DRWR < 50%) in intestinal transplantation (ITX) recipients. METHODS: We studied a group of ITX recipients with DRWR ≤ 50% to unmatched controls who received intestinal allografts with DRWR > 50%...
February 26, 2018: Transplantation
Sergio Henrique Bastos Damous, George Felipe Bezerra Darce, Renato Silveira Leal, Adilson Rodrigues Costa, Pedro Henrique Alves Ferreira, Celso de Oliveira Bernini, Edivaldo Massazo Utiyama
INTRODUCTION: Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. PRESENTATION OF CASE: Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head...
February 15, 2018: International Journal of Surgery Case Reports
Pilar Hernández-Granados, Manuel López-Cano, Salvador Morales-Conde, Filip Muysoms, Josep García-Alamino, José Antonio Pereira-Rodríguez
Incisional hernias are a very common problem, with an estimated incidence around 15-20% of all laparotomies. Evisceration is another important problem, with a lower rate (2.5-3%) but severe consequences for patients. Prevention of both complications is an essential objective of correct patient treatment due to the improved quality of life and cost savings. This narrative review intends to provide an update on incisional hernia and evisceration prevention. We analyze the current criteria for proper abdominal wall closure and the possibility to add prosthetic reinforcement in certain cases requiring it...
February 14, 2018: Cirugía Española
Candace Haddock, Erik D Skarsgard
Gastroschisis is the commonest developmental defect of the anterior abdominal wall in both developed and developing countries. The past 30 years have seen transformational improvements in outcome due to advances in neonatal intensive care and enhanced integration between the disciplines of maternal fetal medicine, neonatology and pediatric surgery. A review of gastroschisis, which emphasizes its epidemiology, multidisciplinary care strategies and contemporary outcomes is timely. Areas covered: This review discusses the current state of knowledge related to prevalence and causation, and postulated embryopathologic mechanisms contributing to the development of gastroschisis...
February 8, 2018: Expert Review of Gastroenterology & Hepatology
Maria V Fraga, Pablo Laje, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N Scott Adzick
AIM OF THE STUDY: To evaluate if gestational age (GA), mode of delivery and abdominal wall closure method influence outcomes in uncomplicated gastroschisis (GTC). METHODS: Retrospective review of NICU admissions for gastroschisis, August 2008-July 2016. Primary outcomes were: time to start enteral feeds (on-EF), time to discontinue parenteral nutrition (off-PN), and length of stay (LOS). MAIN RESULTS: A total of 200 patients with GTC were admitted to our NICU...
February 7, 2018: Pediatric Surgery International
Kosuke Ichida, Hiroshi Noda, Rina Kikugawa, Fumi Hasegawa, Tamotsu Obitsu, Daisuke Ishioka, Rintaro Fukuda, Ayuha Yoshizawa, Shingo Tsujinaka, Toshiki Rikiyama
BACKGROUND: Surgical site infection is one of the most common postoperative complications after gastroenterologic surgery. This study investigated the effect of triclosan-coated sutures in decreasing the incidence of surgical site infections after abdominal wall closure in gastroenterologic surgery. METHODS: A prospective, double-blind, randomized, controlled parallel adaptive group-sequential superiority trial was conducted from March 2014 to March 2017 in a single center...
February 2, 2018: Surgery
Rhiannon L Harries, Julie Cornish, David Bosanquet, Buddug Rees, James Horwood, Saiful Islam, Nadim Bashir, Alan Watkins, Ian T Russell, Jared Torkington
OBJECTIVES: Incisional hernias are common complications of midline abdominal closure. The 'Hughes Repair' combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. There is evidence to suggest this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared Hughes repair with standard mass closure for the prevention of incisional hernia formation. This paper aims to test the feasibility of running a randomised controlled trial of a comparison of abdominal wall closure methods following midline incisional surgery for colorectal cancer, in preparation to a definitive randomised controlled trial...
December 19, 2017: BMJ Open
Z Williams, S Williams, H A Easley, H M Seita, W W Hope
PURPOSE: To evaluate abdominal wall closure knowledge base and technical skills in surgical and OB/GYN residents. METHODS: Residents consented to participate in a skills laboratory and quiz. The skills portion involved closure of a 10-cm incision on a simulated abdominal wall. Participants were timed, filmed, and graded using a standardized grading system. RESULTS: Thirty surgical and OB/GYN residents participated. All residents reported closing the abdominal wall continuously, 97% preferred slowly absorbing sutures (28/29), 97% preferred taking 1-cm bites (29/30), and 93% spaced bites 1 cm apart (27/29)...
December 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
N A Henriksen, E B Deerenberg, L Venclauskas, R H Fortelny, J M Garcia-Alamino, M Miserez, F E Muysoms
INTRODUCTION: Surgical site infection (SSI) is a frequent complication of abdominal surgery causing increased morbidity. Triclosan-coated sutures are recommended to reduce SSI. The aim of this systematic review and meta-analysis was to evaluate the evidence from randomized controlled trials (RCT) comparing the rate of SSI in abdominal surgery when using triclosan-coated or uncoated sutures for fascial closure. METHODS: A systematic literature search was conducted using Medline, EMBASE, the Cochrane library, CINAHL, Scopus and Web of Science including publications until August 2017...
December 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Z F Williams, P Tenzel, W B Hooks, W W Hope
PURPOSE: Research has established that a ≥4:1 suture to wound (S:W) length ratio decreases incisional hernias. We evaluated our ability to obtain a 4:1 S:W length ratio in a surgery residency program. METHODS: Consecutive abdominal wall closures from 12/1/2013 through 4/9/2015 were reviewed. The length of the incisions and amount of suture used were measured. Patient demographics and operative variables were documented and compared related to inability to obtain a 4:1 ratio...
December 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
J F Lock, F Anger, C-T Germer
While intestinal injury is relatively rare in blunt abdominal trauma, it is common in penetrating abdominal trauma. Intestinal injury cannot be detected effectively by computed tomography (CT); therefore penetrating abdominal injury or abdominal signs in blunt trauma require liberal indications for explorative laparotomy. In mass casualty situations patients with hemodynamic instability and abdominal signs should be prioritized for surgery. Besides intra-abdominal hemorrhage the major issue is septic complications due to intestinal perforation...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Nina E Glass, Clay Cothren Burlew, Jens Hahnhaussen, Sebastian Weckbach, Fredric M Pieracci, Ernest E Moore, Philip F Stahel
OBJECTIVE: To investigate the safety and feasibility of performing definitive fracture fixation in multiply injured patients in the presence of an open abdomen after laparotomy. DESIGN: Retrospective observational cohort study. SETTING: Level-I academic trauma center. PATIENTS: Adult polytrauma patients with the presence of an open abdomen after "damage control" laparotomy and associated major fractures of long bones, acetabulum, pelvis, or spine, requiring surgical repair (n = 81)...
December 2017: Journal of Orthopaedic Trauma
Christian Hobeika, Marc-Antoine Allard, Petru-Octav Bucur, Salima Naili, Antonio Sa Cunha, Daniel Cherqui, Denis Castaing, René Adam, Eric Vibert
INTRODUCTION: The optimal management of the open abdomen (OA) after liver transplantation (LT) is unclear. The negative pressure wound therapy (NPWT) has been shown to be safe and can increase the chance for early fascial closure in trauma or septic patients. However, little data are available on the specific setting of LT. We aimed to report our experience of OA after LT, marked by the recent use of NPWT. METHODS: All patients with postponed wall closure after LT, from 2002 to 2014, in a single institution were included and retrospectively analyzed...
December 2017: World Journal of Surgery
Jose Macario Faylona
PURPOSE: The aim of this review was to look at relevant data and research on the evolution of ventral hernia repair. METHODS: Resources including books, research, guidelines, and online articles were reviewed to provide a concise history of and data on the evolution of ventral hernia repair. RESULTS: The evolution of ventral hernia repair has a very long history, from the recognition of ventral hernias to its current management, with significant contributions from different authors...
August 2017: Asian Journal of Endoscopic Surgery
Hüseyin Karagöz, Cihan Şahin, Celalettin Sever, Yalçın Külahçi, Fikret Eren, Ceyhun Cesur, Fuat Yüksel
BACKGROUND/AIM: The pedicled transverse rectus abdominis myocutaneous (TRAM) flap remains widely used as a breast reconstruction technique. The bipedicled TRAM flap is not as preferable as it was formerly, mainly because of its donor site complications. However, in a number of situations, a bipedicled TRAM flap may be the only alternative. Therefore, a three-layer primary closure technique used with bipedicled TRAM flap breast reconstructions that can avoid donor site complications without using a mesh is presented...
June 12, 2017: Turkish Journal of Medical Sciences
Raquel Díaz Ruiz, Marta Castillo Pradillo, Óscar Nogales Rincón, Cecilia González Asanza
Postoperative fistula results in increased morbidity and a longer hospital stay. While surgery is the most common treatment, the endoscopic approach is an increasingly used alternative. A 57-year-old woman underwent surgery for colonic adenocarcinoma, which relapsed as peritoneal carcinomatosis and was managed with chemotherapy and surgery, a biological Permacol™ mesh was used for abdominal wall closure.
April 2017: Revista Española de Enfermedades Digestivas
S D Couto Netto, F Teixeira, C A M Menegozzo, A Albertini, E H Akaishi, E M Utiyama
BACKGROUND: Abdominal wall desmoid type fibromatosis management has been changing over recent years, from an aggressive approach towards a more conservative one. When radical resection is indicated, the surgical team faces the challenge of abdominal wall reconstruction, for which optimal technique is still debated. The present study reports the experience from a single center with abdominal closures after desmoid type fibromatosis resection. MATERIAL AND METHODS: Retrospective analysis of patients who underwent abdominal wall closure after sporadic abdominal desmoid type fibromatosis radical resection from 1982 to 2013...
2017: International Journal of Surgery Case Reports
Lori A Gurien, Deidre L Wyrick, Melvin S Dassinger, Jeffrey M Burford, Steven C Mehl, Marie E Saylors, Samuel D Smith
BACKGROUND: Optimal timing to begin feeds in neonates with gastroschisis remains unclear. We examined if bedside abdominal ultrasound for intestinal motility is a feasible tool to detect return of bowel function in neonates with gastroschisis. METHODS: Neonates born with uncomplicated gastroschisis who underwent closure received daily ultrasound exams. Full motility was defined as peristalsis seen in all quadrants. Average length of time between abdominal wall closure and start of enteral feeds, full ultrasound motility, and clinical characteristics was compared using Student's t-tests...
May 2017: Journal of Pediatric Surgery
Katharina Schib, Marc Schumacher, Martin Meuli, Sasha Tharakan, Ulrike Subotic
Introduction Evidence-based guidelines or protocols regarding the perinatal management of babies born with gastroschisis are lacking. The aim of this work is to evaluate the different current treatment modalities for newborns with gastroschisis during the perinatal period in the German-speaking countries Germany, Austria, and Switzerland. These data could serve as a starting point for the development of a multicenter randomized controlled trial. Materials and Methods A questionnaire was developed with 30 questions divided into five sections: (1) prenatal diagnosis, (2) fetal therapy, (3) mode and timing of delivery, (4) operative management, and (5) postoperative management...
February 9, 2017: European Journal of Pediatric Surgery
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