An Algorithm for Abdominal Wall Reconstruction

Rohrich, Rod J.; Lowe, James B.; Hackney, Fred L.; Bowman, Julie L.; Hobar, P. Craig

doi:10.1097/00006534-200001000-00036

Cited by 205 publications

(133 citation statements)

References 67 publications

Supporting

Mentioning

121

Contrasting

Unclassified

Order By: Relevance

“…9 The size of the prosthesis used to repair incisional hernias is important; it should cover any residual defect plus an additional 6-8cm in all directions from the margins of the hernial aperture and suture intervals should be no more than 2cm to ensure adequate fixation. 10 In present study the maximum incidence of incisional hernia was seen in post tubectomy surgery with 50% in sublay and 38% in onlay group.…”

Section: Discussionmentioning

confidence: 99%

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

et al. 2018

View full text Add to dashboard Cite

Background: Incisional hernia (IH) remains a very frequent postoperative complication and common hernias in middle aged population more commonly in females. The two techniques most frequently used are the onlay repair and sublay repair. Various studies have been conducted to compare the advantages and disadvantages of sublay and onlay mesh repair in incisional hernia and the superiority of sublay mesh repair. These studies whether they hold good for the population is a pertinent question. In view of this, author need to study the appropriate surgical techniques sublay versus onlay repair in the set up.Methods: Author conducted randomized comparative study of 100 patients having incisional hernia admitted to various surgical units of SNMC and HSK Hospital, Bagalkot during the period December 2014 to June 2016.Results: In present study of 100 cases, females have more incidence of incisional hernias than males. In onlay technique seroma formation was found in 72% of patients postoperatively and 4% in sublay technique. Surgical site infection (SSIN) was noticed in 8% of sublay technique whereas 12% in onlay technique. There is no recurrence in sublay group whereas onlay had 12% recurrence.Conclusions: Sublay technique is superior to onlay concerning the hospital stay, complications and recurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Repairs have to be delayed until all inflammation is controlled to ensure an acceptable functional and aesthetic result. Repair should also be delayed if the patient is unstable or reconstructive options are limited and risky [2]. Secondary repairs are made difficult by scar tissue and adhesions.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic Massive Abdominal Wall Defect- A Challenge

Dogra

Sharma

Singh

2005

Medical Journal Armed Forces India

View full text Add to dashboard Cite

“…For the late definitive restoration of the abdominal wall, many flaps that provide contractile muscle and fascial support have been advocated including rectus femoris, latissimus dorsi, tensor fascia latae and vastus lateralis myofascial flaps. [7][8][9][10][11] However, due to the limited rotation arcs and/or small size of the flaps, these defects generally require more than one flap, which limits the usage of these flaps. On the other hand, both the scar and functional loss in donor site are other limiting factors.…”

Section: (A) (B)mentioning

confidence: 99%

“…[25] In 2000, they placed an expander between the internal oblique and transversus abdominis muscles in a traumatic abdominal wall defect. [11] We placed expanders in subcutaneous plane as used previously in the reconstruction of abdominal wall defects. [12][13][14] As distinct from previous studies in our protocol, an enduring abdominal wall was acquired by lamination of the expanded abdominal skin and subcutaneous tissue and composite mesh together.…”

Section: (A) (B)mentioning

confidence: 99%

“…Many methods including myofascial rotation flaps, distant flaps and tissue expansion have been advocated to repair this ventral hernia. [7][8][9][10][11][12][13][14] However, it cannot be expected to successfully close all kinds of defects byusing only one technique. The state of the components of the abdominal wall and the overall medical status of the patient are vitally important as well as the size of the defect for selecting the reconstructive technique.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Staged Repair Of Severe Open Abdomens Due To High-Energy Gunshot Injuries With Early Vacuum Pack And Delayed Tissue Expansion And Dual-Sided Meshes

Alhan

Şahin

Güzey

et al. 2015

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

Staged repair of severe open abdomens due to high-energy gunshot injuries with early vacuum pack and delayed tissue expansion and dual-sided meshes series of intra-abdominal interventions. At the end of this long treatment period, persistent intestinal edema and retraction of the abdominal wall are the main factors why fascias cannot be connected at an early time. Moreover, in severe abdominal traumas like the ones caused by high-energy gunshots, trauma may not only affect the intra-abdominal components but may also cause loss of domain of the abdominal wall.A staged reconstruction protocol is required for this type of patients. Firstly, a temporary closing of the viscera is provided, and subsequently, permanent repair of the abdominal wall should be done. Many procedures have been advocated to close the viscera at the first stage. [1][2][3][4][5][6] The fundamental principle in all of these procedures is forming the granulation tissue on the open abdominal wall and closing it with partial-thickness skin graft (PTSG ABSTRACT BACKGROUND: Open abdomen is a salvage procedure that prevents catastrophes after severe intraabdominal traumas. However, following this life saving attempt, it is mostly not feasible to close the abdomen immediately after the recovery of intraabdominal injuries. Consequently, a staged reconstruction is required, and the first stage is usually a temporary closing approach. At the end of this stage, resulting giant "ventral hernia" is a burden for both the patient and the surgeon. Therefore a permanent repair is subsequently needed. Although there are many treatment modalities described for this goal, etiologies like high-energy gunshots may cause an exactly nuisance scene which can limit treatment options and reduce final success. Herein, it was the objective of this study to present our staged protocol to restore the abdominal wall defect and strategy for optimizing the results in such conundrum cases. METHODS:Treatment was performed on nine male patients suffering from severe open abdomen due to high-energy gunshot injury. In all patients, temporary closure was provided by negative pressure wound treatment applied directly to the viscera and followed by skin grafting. Late permanent closure was performed with the lamination of expanded abdominal skin and dual-sided meshes. RESULTS:The follow-up period ranged between 24 months to 4.5 years (mean, 3 years). During this period, no recurrence of ventral hernia, enteric fistula formation, abdominal infection and seroma formation was observed in any patient. CONCLUSION:In this study, NPWT, tissue expansion and dual-sided mesh were used together as a staged procedure for optimizing the results in the clinical scenario of an open abdomen due to high-energy gunshot wound. Results were highly satisfactory for patients and acceptable aesthetically.

show abstract

An Algorithm for Abdominal Wall Reconstruction

Cited by 205 publications

References 67 publications

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

Post-traumatic Massive Abdominal Wall Defect- A Challenge

Staged Repair Of Severe Open Abdomens Due To High-Energy Gunshot Injuries With Early Vacuum Pack And Delayed Tissue Expansion And Dual-Sided Meshes

Contact Info

Product

Resources

About