Fascial incisions heal faster than skin: A new model of abdominal wall repair

Franz, Michael; Smith, Paul D.; Wachtel, Thomas L.; Wright, Terry E.; Kuhn, M. Ann; Ko, Francis; Robson, Martin C.

doi:10.1067/msy.2001.110220

Cited by 58 publications

(71 citation statements)

References 12 publications

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“…This was entirely related to acute skin wound failure and clearly a result of skin clips having been an incorrect strategy for closing the skin. However, the studies that reported the use of skin clips as a way of closing skin did not report any difficulties or complications [13,17,18,19]. The skin clips were first replaced with absorbable sutures in experiment B, and later with single stitches of a nonabsorbable suture in experiment C, but the results continued to be bad, which surprisingly was also not found in previous studies using this specific suture technique [14,15,33].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the existing models has been developed to investigate IH and is based on roughly the same surgical procedure as in the present model with a paramedian skin incision and a median fascial incision [12,13,14,15,17,18,19]. Our animal model utilized the same surgical procedure; however, the other models primarily focused on creating regular abdominal wall defects (IH) for testing different treatment modalities such as meshes, growth factors, and biologic treatments.…”

Section: Discussionmentioning

confidence: 99%

“…1). The linea alba was exposed and visualized, and a standardized 5-cm myofascial full-thickness incision was performed as described earlier [12,13,14,15,17,18,19]. Great care was taken not to damage the underlying organs.…”

Section: Methodsmentioning

confidence: 99%

“…The vast majority of existing experimental IH models have focused on creating regular fascia defects and subsequently applying treatment modalities such as meshes or biologic growth factors [11,12,13,14,15,16,17]. Therefore, these existing models are less suitable for investigating the changes in the early fascia healing after abdominal incisions that potentially may lead to IH formation.…”

Section: Introductionmentioning

confidence: 99%

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An Experimental Animal Model for Abdominal Fascia Healing after Surgery

Burcharth

Pommergaard²,

Klein³

et al. 2013

Eur Surg Res

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Background: Incisional hernia (IH) is a well-known complication after abdominal surgical procedures. The exact etiology of IH is still unknown even though many risk factors have been suggested. The aim of this study was to create an animal model of a weakly healed abdominal fascia that could be used to evaluate the actively healing fascia. Such an animal model may promote future research in the prevention of IH. Methods: 86 male Sprague-Dawley rats were used to establish a model involving six experiments (experiments A-F). Mechanical testing of the breaking strength of the healed fascia was performed by testing tissue strips from the healed fascia versus the unincised control fascia 7 and 28 days postoperatively. Results: During the six experiments a healing model was created that produced significantly weaker coherent fascia when compared with the control tissue measured in terms of mechanical breaking strength. This new animal model employed myofascial closing after a full thickness abdominal incision using a running suture with fast-absorbable suture material. This technique produced a weak myofascial layer compared with the control tissue measured in terms of breaking strength after both 7 and 28 days. Conclusion: It was possible to create a healed but weak abdominal fascia in rats with a minimum of defects after incision using a running suture technique in the fascia. In contrast to other models, regular tissue defects were absent, and the model can therefore be used to evaluate the changes, both histological and mechanical, in the actively healing fascia, which may lead to incisional herniation. Furthermore, the model may also be used to study interventions performed to promote healing. This contrasts with existing models with regular fascia defects, which are not well suited for this purpose.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An Experimental Animal Model for Abdominal Fascia Healing after Surgery

Burcharth

Pommergaard²,

Klein³

et al. 2013

Eur Surg Res

View full text Add to dashboard Cite

show abstract

“…At most 30% at 32N/cm (47) Compliance ( Figure 3C) The amount of displacement or deformation in response to a unit force Pore size ( Figure 3D) The area between mesh filaments Pores >75 µm allow macrophage infiltration, neovascularization and incorporation (74); pores >1 mm prevent granuloma bridging for polypropylene mesh (75,76) Effective pores ( Figure 3E Degradation Disappearance of the mesh material 6 months for scar tissue to reach its maximum strength; (23,88,135) for adhesion formation the timeframe is unclear (128)…”

Section: Mechanical Propertiesmentioning

confidence: 99%