Flap Surgical Techniques For Incisional Hernias Reccurences. A Swine Experimental Model

Abstract

Background and aimIn the age of synthetic prostheses most of hernia studies include a careful examination of the various types of prosthesis, their characteristics and their repair indications. Biological prostheses are also beginning to draw attention. But in terms of recurrence especially for poor or developing countries, the discussion is different, due to their high cost which makes them difficult to afford. In this article we present new flap reconstruction techniques for the reconstruction of the abdominal wall versus mesh repair, applied on swine models, outline the results of each technique, and specify the indications for their use.MethodsAn experimental protocol using four swine models (PIC-FII-337 hybrid breed pigs), five months old, was conducted. All animal care and operative procedures were studied following the protocol approved by the Ethics Committee of the University of Medicine and Pharmacy resolution no. 281/2014 of the Department of Surgery of the University of Agricultural Sciences and Veterinary Medicine); the study was carried out between November 2015 and February 2016. The primary objective was to compare the effect of surgical strategies in the treatment of the abdominal wall defect using variable flaps versus mesh repair in a large-animal models. Physical examination and ultrasound imaging of the abdominal wall repair were done on determined periods, during one month. The complications occurring after the abdominal wall repair were edema, collections, superficial dehiscence an recurrences.ResultsNo recurrences were reported at one month results, all seromas reported were solved over time by natural drainage. Superficial necrosis appeared in two swine models and superficial dehiscence occurred in one model, the perforator ”plus” flap. Mesh infection was detected in the “onlay” swine model.ConclusionsIn terms of recurrences, contaminated abdominal wall defects or other contraindications to the use of prosthetic materials, biological mesh repair or flap surgery are the only surgical options. Based on our findings and considering the high cost reported by the biological meshes use, flap surgery becomes the suitable treatment for such cases, allowing a good reconstruction of the abdominal wall.

Hernioplasty with Peritoneal Flap for the Surgical Treatment of Umbilical Hernia in Swine

“…According to Al-Sobayil and Ahmed, herniorrhaphy is the most suitable procedure for the treatment of many types of hernia but, in the case of complications due to the formation of adhesions of the hernial sac with the viscera or the presence of large umbilical hernias, some authors prefer to perform hernioplasty with implantation of prosthetic material [ 34 , 35 ] in order to perform a tension-free suture and avoid any wound dehiscence. This allows you to avoid the ischemia that is created following the incision of the tissues, allowing the formation of collagen and therefore better scarring and healing [ 34 , 35 ].…”