Mesh Sutured Repairs of Abdominal Wall Defects

Moradian

2020

Advances in Surgery

Self Cite

The ultimate tensile strength of newly apposed tissue is the sum of the strength of the physical construct holding the tissues and the strength of biologic healing. For successful laparotomy closure or incisional hernia repair, the total strength of the repair must remain greater than the opposing forces applied at the suture/ tissue interface. Given limited progress over recent years, recent research focuses on an improved distribution of forces at the suture/tissue interface that can limit tissue tearing, suture pull-through, and incisional hernia formation.

Section: Mesh Sutured Repairsmentioning

confidence: 99%

Fascial Closure

Moradian

2020

Advances in Surgery

Self Cite

“…As previously described, 3 a light-weight, macroporous, uncoated polypropylene mesh (PROLENE ® Soft Prolene Mesh, Ethicon, Somerville, NJ) 10 Â 14 inches in size (30.5 cm Â 35.6 cm) was cut along the blue lines into 2 cm wide pieces in order to fabricate mesh strips in this off-label use of the product. Subcutaneous tissue was elevated off of the abdominal wall only as necessary in order to achieve a 1 cm wide bite of unscarred abdominal wall.…”

Section: Mesh Sutured Techniquementioning

confidence: 99%

“…We recently described a technique called a "mesh sutured repair" using strips of light-weight macroporous polypropylene mesh passed through the abdominal wall and tied like sutures to achieve closure. 3 Mesh sutured repairs aim to capitalize on the biomechanical benefits of force distribution to reduce tearing, while minimizing the drawbacks of the total volume of implanted material and the required tissue dissection. Pre-clinical studies demonstrated the biomechanical benefits over conventional suture repair, with decreased suture pull-through and increased early tensile strength.…”

Section: Introductionmentioning

confidence: 99%

Mesh sutured repairs of contaminated incisional hernias

The American Journal of Surgery

Lanier

Souza

et al. 2018

Self Cite

“…Methods described for this study include the use of bone anchors 43 , 44 , 48 , 49 and direct suture fixation. 50 The senior author has developed a method of hernia repair using 2-cm strips of macroporous polypropylene mesh 51 , 52 that are used as sutures. A strip of mesh has the advantage of a larger surface area and, thus, a greater force distribution across the closure when compared with a single strand of suture.…”

Section: Introductionmentioning

confidence: 99%

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

Kearney

Plastic and Reconstructive Surgery - Global Open

2020

Self Cite

Background: Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically difficult aspect of these repairs is fixating the abdominal wall to the iliac crest. The senior author has developed a method of repair using 2-cm strips of mesh. In this article, we present a description of 4 patients treated with this technique. Methods: We included 4 adult patients who underwent traumatic flank hernia repairs by the senior author. We excluded incisional hernias and patients who received a planar sheet of mesh. Demographics and outcomes collected included length of stay, follow-up time, and complications. Results: The average age was 38.5 years. Three hernias were due to motor vehicle collision injuries, and 1 was a crush injury at work. No planar meshes or bone anchors were used. No patients required component separation. There were no instances of surgical site infection, hematoma, or wound breakdown. All repairs were intact at the time of last follow-up (average, 24.3 months; range, 4–48.7 months). Conclusions: Traumatic flank hernias are rare injuries that can be difficult to address. Here, we describe a technique of primary repair with mesh strips that distribute the forces of repair across a greater surface area than can be achieved with sutures. Placing drill holes through the iliac crest avoids the cost and complexity of suture anchors.