A Patient-Centered Appraisal of Outcomes following Abdominal Wall Reconstruction

Sosin, Michael; Patel, Ketan M.; Albino, Frank P.; Nahabedian, Maurice Y.; Bhanot, Parag

doi:10.1097/01.prs.0000436860.47774.eb

Cited by 48 publications

(23 citation statements)

References 44 publications

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“…20,21 Three of the systematic reviews compared anterior with endoscopic anterior components separation, a fourth one compared different techniques of components separation (2-part study), the fifth study assessed different surgical methods of giant hernia repair including hernioplasty and components separation, and the sixth paper investigated the quality of life following open hernia repair including satisfaction from component separation technique. [20][21][22][23][24][25] The 3 retrospective studies comparing posterior components separation with other techniques that met the inclusion criteria are Krpata et al, Cobb et al, and Holihan et al 23,26,27 The different characteristics of these are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Posterior Components Separation With Transversus Abdominis Release (TAR) Versus Alternative Techniques of Components Separation: Systematic Review

Sleiwah

McAllister

2018

International Surgery

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The aim of this study is to assess the clinical effectiveness of posterior abdominal wall components separation with transversus abdominis muscle release (PCS-TAR) in the management of ventral abdominal hernias. Ventral abdominal hernias complicate up to 11% of laparotomy wounds. Surgical management includes primary repair, hernioplasty, flaps, and components separation. A technique has been described to close large abdominal defects by releasing bilateral myofascial flaps of rectus abdominis from external oblique and advancing these flaps to the midline. Minimally invasive and endoscopic techniques were subsequently developed to reduce complications. A recently described method is PCS-TAR. The hypothesis is that PCS-TAR for abdominal wall reconstruction is associated with lower rates of wound complications and hernia recurrence than other components separation techniques. A comprehensive search of databases including Medline, Embase, Cochrane Central Register of Controlled Trials, and Scopus was conducted in accordance with PRISMA guidelines, looking for the primary outcomes of hernia recurrence and wound complications following different techniques of components separation. Inclusion and exclusion criteria were defined. The quality of studies was examined independently by 2 assessors. A total of 363 studies were identified. Three retrospective comparative studies met the inclusion criteria. No randomized control trial comparing different techniques of abdominal wall components separation was identified. No technique could be identified as superior to others, due to a paucity of the literature. However, based on a few retrospective cohort studies, PCS-TAR emerges as a well-tolerated new technique, with a low incidence of wound complications and hernia recurrence.

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Section: Resultsmentioning

confidence: 99%

Posterior Components Separation With Transversus Abdominis Release (TAR) Versus Alternative Techniques of Components Separation: Systematic Review

Sleiwah

McAllister

2018

International Surgery

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“…In order to accurately identify a given species, DNA barcoding using the cytochrome C oxidase subunit 1 gene is recommended ( Siddall et al, 2007a ). Although leech species differ in salivary protein ( Baskova et al, 2008 ; Siddall et al, 2011 ) and gut microbiota composition ( Graf, 1999 ; Siddall et al, 2007b ; Laufer et al, 2008 ; Whitaker et al, 2014 ), it remains unknown whether or not the efficacy of leech therapy is dependent on the leech species used.…”

Section: The Medicinal Leechmentioning

confidence: 99%

“…In each host species, the microbial community is dominated by Aeromonas and Bacteroidetes spp. ( Worthen et al, 2006 ; Siddall et al, 2007b , 2011 ; Laufer et al, 2008 ; Whitaker et al, 2014 ). In H. verbana , the predominant Bacteroidetes species was initially termed Rikenella- like and was recently renamed as Mucinivorans hirudinis , a member of the Rickenellaceae ( Worthen et al, 2006 ; Nelson et al, 2015b ).…”

Section: The Leech Crop Microbiotamentioning

confidence: 99%

Host Matters: Medicinal Leech Digestive-Tract Symbionts and Their Pathogenic Potential

et al. 2016

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Digestive-tract microbiota exert tremendous influence over host health. Host-symbiont model systems are studied to investigate how symbioses are initiated and maintained, as well as to identify host processes affected by resident microbiota. The medicinal leech, Hirudo verbana, is an excellent model to address such questions owing to a microbiome that is consistently dominated by two species, Aeromonas veronii and Mucinivorans hirudinis, both of which are cultivable and have sequenced genomes. This review outlines current knowledge about the dynamics of the H. verbana microbiome. We discuss in depth the factors required for A. veronii colonization and proliferation in the leech crop and summarize the current understanding of interactions between A. veronii and its annelid host. Lastly, we discuss leech usage in modern medicine and highlight how leech-therapy associated infections, often attributable to Aeromonas spp., are of growing clinical concern due in part to an increased prevalence of fluoroquinolone resistant strains.

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“…[1,2] Repair of primary and recurrent abdominal wall hernias with component separation and Strattice acellular dermal matrix is a technique where plastic surgeons and general surgeons work closely together to close abdominal walls and optimize functional as well as aesthetic outcomes reestablishing abdominal core health. [3,4] There are many different locations of hernias encountered by the general surgeon and plastic surgeon team: ventral, inguinal, umbilical, parastomal as well as the lateral abdominal wall ( ank). [5] Hernias are prevalent in the population and their presence is not inconsequential.…”

Section: Introductionmentioning

confidence: 99%

A Load Sharing Principle in Abdominal Wall Reconstruction. Communication and Collaboration Among Plastic & Reconstructive Surgeons, Oncologic Surgeons, and General Surgeons.

Dickinson

Vu-Huynh

et al. 2020

Preprint

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Background: Abdominal wall reconstruction of ventral hernias can be challenging. Patients have undergone successful treatment of cancer or other intra-abdominal processes and have worked hard to get back to a “normal” life. Successful repair of abdominal wall hernias can be difficult as many comorbidities persist. Previous radiation, ongoing smoking, or overall protein malnutrition may affect wound healing and overall outcome. Surgical teams need to communicate to maximize repair success and decrease recurrence. Purpose: To create a systematic approach from our current method of abdominal wall reconstruction that facilitates communication between general surgeons and plastic and reconstructive surgeons for optimizing hernia repair outcomes. Methods: A retrospective chart review was done on patients who underwent abdominal wall reconstruction of ventral hernias and recurrent hernias with component separation and placement of strattice acellular dermal matrix or synthetic mesh over a 10 year period. Pre-op imaging consisted of an abdominal/pelvic CT-scan. A surgical flight plan was created to determine a plane of Strattice insertion and abdominal wall exposure. Pre/post-operative CT-scans were compared as well as before and after photographs. Patient satisfaction was assessed subjectively in follow-up appointments. Results: The most commonly encountered clinical scenarios were placed into a pictorial essay and a step by step approach to abdominal wall reconstruction was then created. Strattice or synthetic mesh were placed using a “load-sharing” principle and restoration of a dynamic abdominal wall was associated with high patient satisfaction, a more functional repair, and a lower incidence of recurrence. Conclusions: Successful repair of primary and recurrent abdominal wall hernias requires communication between general surgeons and plastic & reconstructive surgeons. Incision placement is important for adequate exposure and the ability to place transfascial sutures. T-junction skin breakdown and seroma formation can be minimized by maintaining blood supply and minimizing dead space. High protein nutritional stores are important for expeditious healing.

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A Patient-Centered Appraisal of Outcomes following Abdominal Wall Reconstruction

Abstract: Therapeutic, III.

Cited by 48 publications

References 44 publications

Posterior Components Separation With Transversus Abdominis Release (TAR) Versus Alternative Techniques of Components Separation: Systematic Review

Posterior Components Separation With Transversus Abdominis Release (TAR) Versus Alternative Techniques of Components Separation: Systematic Review

Host Matters: Medicinal Leech Digestive-Tract Symbionts and Their Pathogenic Potential

A Load Sharing Principle in Abdominal Wall Reconstruction. Communication and Collaboration Among Plastic & Reconstructive Surgeons, Oncologic Surgeons, and General Surgeons.

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A Patient-Centered Appraisal of Outcomes following Abdominal Wall Reconstruction

Abstract: Therapeutic, III.

Cited by 48 publications

References 44 publications

Posterior Components Separation With Transversus Abdominis Release (TAR) Versus Alternative Techniques of Components Separation: Systematic Review

Posterior Components Separation With Transversus Abdominis Release (TAR) Versus Alternative Techniques of Components Separation: Systematic Review

Host Matters: Medicinal Leech Digestive-Tract Symbionts and Their Pathogenic Potential

A Load Sharing Principle in Abdominal Wall Reconstruction. Communication and Collaboration Among Plastic &amp; Reconstructive Surgeons, Oncologic Surgeons, and General Surgeons.

Contact Info

Product

Resources

About

A Load Sharing Principle in Abdominal Wall Reconstruction. Communication and Collaboration Among Plastic & Reconstructive Surgeons, Oncologic Surgeons, and General Surgeons.