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Reconstruction of abdominal wall

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https://www.readbyqxmd.com/read/28792430/component-separation-technique-for-repair-of-massive-abdominal-wall-defects-at-a-pediatric-hospital
#1
James D Vargo, Michael T Larsen, Gregory D Pearson
BACKGROUND: Massive defects of the abdominal wall are commonly repaired with the component separation technique (CST) when insufficient tissue exists to close the defect primarily. Although the utility of CST has been documented in cases of large ventral hernias in adults, its application to congenital and acquired defects in pediatric patients has been largely unreported. This study is a retrospective case series discussing the success of CST at a large pediatric hospital. METHODS: Seven patients with massive abdominal wall defects, including ventral hernia and omphalocele, repaired with CST at a pediatric hospital were identified as candidates...
November 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28762694/pelvic-organ-prolapse
#2
REVIEW
Cheryl B Iglesia, Katelyn R Smithling
Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is primarily associated with pregnancy and vaginal delivery, which lead to direct pelvic floor muscle and connective tissue injury. Hysterectomy, pelvic surgery, and conditions associated with sustained episodes of increased intra-abdominal pressure, including obesity, chronic cough, constipation, and repeated heavy lifting, also contribute to prolapse...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28744163/cesarean-section-after-abdominal-mesh-repair-for-pregnancy-related-desmoid-tumor-a-case-report
#3
Sara Ooi, Harry Ngo
We report the case of a 32-year-old gravida 2 para 1 woman with a background of partially resected desmoid tumor (DT) arising from the previous cesarean section (CS) scar. This case details the management of her DT by surgical resection and mesh repair and second pregnancy following this. Pregnancy-related DTs are a relatively rare entity, and there is a paucity of literature regarding their management during pregnancy. There are only five reported cases of DTs arising from CS scars. To our knowledge, this is the only report to illustrate that subsequent CS is possible after desmoid resection and abdominal mesh repair...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28740797/pain-management-in-abdominal-wall-reconstruction
#4
Ibrahim Khansa, Andrew Koogler, Jesse Richards, Richard Bryant, Jeffrey E Janis
BACKGROUND: In abdominal wall reconstruction, adequate pain control and minimization of narcotic consumption are essential to improving patient outcomes and satisfaction. Previous studies have examined the role of individual strategies, such as neuraxial analgesia and multimodal analgesia. However, there has not been a study that examined all potential determinants of postoperative narcotic requirements, including intraoperative strategies. METHODS: Consecutive patients who underwent abdominal wall reconstruction were reviewed...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740793/donor-site-complications-and-remnant-of-rectus-abdominis-muscle-status-after-transverse-rectus-abdominis-myocutaneous-flap-reconstruction
#5
Prakasit Chirappapha, Noppadol Trikunagonvong, Duangkamon Prapruttam, Sasiprapa Rongthong, Panuwat Lertsithichai, Thongchai Sukarayothin, Monchai Leesombatpaiboon, Rujira Panawattanakul, Panya Thaweepworadej
BACKGROUND: Transverse rectus abdominis myocutaneous (TRAM) flap reconstruction after mastectomy in breast cancer patients has become one of the milestones in breast reconstruction. There are several techniques that have been used in an attempt to minimize untoward complications. We present the whole muscle with partial sheath-sparing technique that focuses on the anatomy of arcuate line and the closure of the anterior abdominal wall techniques with mesh and determine factors associated with its complications and outcomes...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740773/botulinum-toxin-a-as-an-adjunct-to-abdominal-wall-reconstruction-for-incisional-hernia
#6
Sinor Soltanizadeh, Frederik Helgstrand, Lars N Jorgensen
BACKGROUND: Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST) for repair of large incisional hernias. Current literature on the administration of BTA as adjunct to surgical repair of abdominal incisional hernias was investigated. METHODS: The electronic databases PubMed and Embase were searched for eligible studies...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28733746/comparative-analysis-of-perioperative-outcomes-of-robotic-versus-open-transversus-abdominis-release
#7
Luis A Martin-Del-Campo, Adam S Weltz, Igor Belyansky, Yuri W Novitsky
BACKGROUND: Transversus abdominis release (TAR) has evolved as an effective approach to complex abdominal wall reconstructions. Although the role of robotics in hernia surgery is rapidly expanding, the benefits of a robotic approach for abdominal wall reconstruction have not been established well. We aimed to compare the impact of the application of robotics to the TAR procedure on the perioperative outcomes when compared to the open TAR repairs. METHODS: Case-matched comparison of patients undergoing robotic TAR (R-TAR) at two specialized hernia centers to a matched historic cohort of open TAR (O-TAR) patients was performed...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28733734/combined-in-vivo-and-ex-vivo-analysis-of-mesh-mechanics-in-a-porcine-hernia-model
#8
Lindsey G Kahan, Spencer P Lake, Jared M McAllister, Wen Hui Tan, Jennifer Yu, Dominic Thompson, L Michael Brunt, Jeffrey A Blatnik
BACKGROUND: Hernia meshes exhibit variability in mechanical properties, and their mechanical match to tissue has not been comprehensively studied. We used an innovative imaging model of in vivo strain tracking and ex vivo mechanical analysis to assess effects of mesh properties on repaired abdominal walls in a porcine model. We hypothesized that meshes with dissimilar mechanical properties compared to native tissue would alter abdominal wall mechanics more than better-matched meshes. METHODS: Seven mini-pigs underwent ventral hernia creation and subsequent open repair with one of two heavyweight polypropylene meshes...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28730275/comparative-analysis-of-open-and-robotic-transversus-abdominis-release-for-ventral-hernia-repair
#9
James G Bittner, Sameer Alrefai, Michelle Vy, Micah Mabe, Paul A R Del Prado, Natasha L Clingempeel
BACKGROUND: Transversus abdominis release (TAR) is a safe, effective strategy to repair complex ventral incisional hernia (VIH); however, open TAR (o-TAR) often necessitates prolonged hospitalization. Robot-assisted TAR (r-TAR) may benefit short-term outcomes and shorten convalescence. This study compares 90-day outcomes of o-TAR and r-TAR for VIH repair. METHODS: A single-center, retrospective review of patients who underwent o-TAR or r-TAR for VIH from 2015 to 2016 was conducted...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28723751/early-laparotomy-and-timely-reconstruction-for-patients-with-abdominal-electrical-injury-five-case-reports-and-literature-review
#10
REVIEW
Pi-Hong Zhang, Zan Liu, Li-Cheng Ren, Ji-Zhang Zeng, Geng-Wen Huang, Mu-Zhang Xiao, Jie Zhou, Peng-Fei Liang, Ming-Hua Zhang, Xiao-Yuan Huang
INTRODUCTION: High-tension electricity can cause devastating injuries that may result in abdominal wall loss, visceral damage, and sometimes major threat to life. The visceral organ may be exposed after debridement and require flap cover, but the tensile strength of abdominal wall may be lack even if flap transplanted. METHODS: From April 2007 through May 2015, 5 patients with severe abdominal electrical injury were treated at our hospital. Exploratory laparotomy was performed based on their clinical manifestations and debridement findings of abdominal wall at early stage, and decision regarding technique for reconstruction of abdominal wall was based on an assessment of the location and extent of the defect...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28717912/management-of-the-open-abdomen-after-liver-transplantation
#11
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...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28710505/application-of-human-acellular-breast-dermal-matrix-abdm-in-implant-based-breast-reconstruction-an-experimental-study
#12
Nahid Nafisi, Mohammad Esmaeil Akbari, Fatemeh Mahjoub, Mohammad Javad Mohseni, Shabnam Sabetkish, Reza Khorramirouz, Mona Tehrani, Abdol-Mohammad Kajbafzadeh
BACKGROUND: The use of acellular dermal matrices (ABDM) has become more common for breast reconstruction to improve postoperative outcomes. We evaluated the efficacy of breast reconstruction by the application of human ABDM in a sheep model. METHODS: The sheep in group I (GI) (N = 4) underwent the following procedures on the right side: (1) breast reconstruction using human ABDM after total mastectomy, (2) human ABDM under the skin, near the breast area and on the left side, (3) fat injection and human ABDM after partial mastectomy, and (4) replacement of ABDM in the abdominal wall far from the breast...
July 14, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28705101/abdominal-wall-expanding-system-obviates-the-need-for-lateral-release-in-giant-incisional-hernia-and-laparostoma
#13
Dietmar Eucker, Andreas Zerz, Daniel C Steinemann
BACKGROUND: In large incisional hernias and after laparostoma midline closure may be impossible. A novel abdominal wall expander system (AWEX) is proposed and evaluated. METHODS: In patients with large incisional hernias and laparostoma where primary midline closure was impossible, AWEX was used. Patients undergoing abdominal wall reconstruction using AWEX between May 2012 and December 2015 were included. Intraoperative the abdominal wall was stretched by attaching the midline fascia borders to a retraction system under tension for 30 minutes...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28671890/management-of-infected-mesh-after-abdominal-hernia-repair-systematic-review-and-single-institution-experience
#14
Valeriy Shubinets, Martin J Carney, David L Colen, Michael N Mirzabeigi, Jason M Weissler, Michael A Lanni, Benjamin M Braslow, John P Fischer, Stephen J Kovach
BACKGROUND: Mesh infection after abdominal hernia repair is a devastating complication that affects general and plastic surgeons alike. The purpose of this study was 3-fold: (1) to determine current evidence for treatment of infected abdominal wall mesh via systematic review of literature, (2) to analyze our single-institution experience with treatment of infected mesh patients, and (3) to establish a framework for how to approach this complex clinical problem. METHODS: Literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, followed by single-institution retrospective analysis of infected mesh patients...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28668592/physiologic-musculofascial-compliance-following-reinforcement-with-electrospun-polycaprolactone-ureidopyrimidinone-mesh-in-a-rat-model
#15
Lucie Hympanova, Marina Gabriela Monteiro Carvalho Mori da Cunha, Rita Rynkevic, Manuel Zündel, Monica Ramos Gallego, Jakob Vange, Geertje Callewaert, Iva Urbankova, Frank Van der Aa, Edoardo Mazza, Jan Deprest
PURPOSE: Electrospun meshes may be considered as substitutes to textile polypropylene implants. We compared the host response and biomechanical properties of the rat abdominal wall following reinforcement with either polycaprolactone (PCL) modified with ureidopyrimidinone-motifs (UPy) or polypropylene mesh. METHODS: First we measured the response to cyclic uniaxial load within the physiological range both dry (room temperature) and wet (body temperature). 36 rats underwent primary repair of a full-thickness abdominal wall defect with a polypropylene suture (native tissue repair), or reinforced with either UPy-PCL or ultra-light weight polypropylene mesh (n = 12/group)...
June 27, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28664523/a-case-of-incisional-hernia-repair-using-composix-mesh-prosthesis-after-antethoracic-pedicled-jejunal-flap-reconstruction-following-an-esophagectomy
#16
Atsushi Yasuda, Takushi Yasuda, Hiroaki Kato, Mitsuru Iwama, Osamu Shiraishi, Yoko Hiraki, Yumiko Tanaka, Masayuki Shinkai, Motohiro Imano, Yutaka Kimura, Haruhiko Imamoto
BACKGROUND: An incisional hernia in a case of antethoracic pedicled jejunal flap esophageal reconstruction after esophagectomy is a very rare occurrence, and this hernia was distinctive in that the reconstructed jejunum had passed through the hernial orifice; a standard surgical treatment for such a presentation has not been established. Herein, we describe a case of repair using mesh prosthesis for an atypical and distinctive incisional hernia after antethoracic pedicled jejunal flap esophageal reconstruction...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28657247/giant-desmoid-tumour-of-the-thorax-following-latissimus-dorsi-and-implant-breast-reconstruction-case-report-and-review-of-the-literature
#17
A M Collins, A M Granahan, D G Healy, C A Lawlor, S P O'Neill
The case of a giant thoracic desmoid tumour in a 44-year-old woman, who presented two years following a breast reconstruction with a latissimus dorsi (LD) flap and implant, is reported. Clinical findings included a rapidly growing, painless mass. Computed tomography (CT) suggested skin and intercostal soft tissue invasion. The tumour was resected en bloc with the LD muscle, implant capsule and underlying rib segments. The resultant thoracic and abdominal wall defects were reconstructed with Dualmesh® and polypropylene meshes respectively...
March 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28654582/predictors-classification-and-management-of-umbilical-complications-in-diep-flap-breast-reconstruction
#18
Min-Jeong Cho, Sumeet S Teotia, Nicholas T Haddock
BACKGROUND: In recent years, the deep inferior epigastric perforator (DIEP) flap has become the workhorse flap for autologous breast reconstruction. Despite increased reports on DIEP flaps, umbilical complications have not been previously studied. The aesthetics of the umbilicus dictates the beauty of the abdomen, and it is critical for plastic surgeons to minimize the scarring of the umbilicus. In this study, we retrospectively reviewed patients who underwent DIEP flaps to determine the predictors of umbilical complications, and created a classification system of these wounds...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28645924/anterior-abdominal-wall-extraosseous-osteosarcoma-occurring-40-years-after-para-aortic-irradiation
#19
Muhammad Furrukh, Asim Qureshi, Nadira Mamoon, Menahil Fatima
Extraskeletal osteosarcomas (OSs) are highly malignant soft tissue tumours associated with a poor prognosis. Only a few records of these rare aggressive neoplasms have been reported in the literature.We describe the case of a 49-year-old man, who presented to our tertiary care centre with a painful isolated lump around the umbilicus. After surgical biopsy, imaging and subsequent pathological analysis, the swelling was diagnosed to be a localised extraskeletal OS. He received previous radiation as treatment for testicular seminoma 40 years ago, which has been in remission ever since...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28632147/crossover-iliofemoral-bypass-graft-through-tension-free-abdominal-wall-repair-mesh
#20
Mircea Muresan, Ovidiu Jimborean, Gabriela Jimborean, Radu Neagoe, Serban Bancu, Muresan Simona, Cristian Borz
INTRODUCTION: In vascular surgery the crossover iliofemoral bypass grafting is a well-known surgical technique. In general surgery the repair of an abdominal defect using a Polypropylene mesh is also a standard procedure. A particular technique is defined by the performance of these 2 separate procedures inside a single operation in which the crossover arterial graft is directed from the retroperitoneal space toward the contra-lateral femoral bifurcation through a Polypropylene mesh which closes the musculoaponeurotic layers of the abdominal wall...
June 8, 2017: Annali Italiani di Chirurgia
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