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At least 37 records · Page 2Linked to original sources
PubMed2001

Restoration of abdominal wall integrity as a salvage procedure in difficult recurrent abdominal wall hernias using a method of wide myofascial release.

The management of primary and recurrent giant incisional hernias remains a complex and frustrating challenge even with multiple alloplastic and autogenous closure options. The purpose of this study was to develop a reconstructive technique of restoring abdominal wall integrity to a subcategory of patients, who have failed initial hernia therapy, by performing superior and lateral myofascial release. Over a 1.5-year period, 10 patients with previously unsuccessful treatment of abdominal wall hernias, using either primary repair or placement of synthetic material, were studied. The patients had either recurrence of the hernia or complications such as infections requiring removal of synthetic material. The hernias were not able to be treated with standard primary closure techniques or synthetic material. The average defect size was 19 x 9 cm. Each patient underwent wide lysis of bowel adhesions releasing the posterior abdominal wall fascia to the posterior axillary line, subcutaneous release of the anterior abdominal wall fascia to a similar level, and complete removal of any synthetic material (if present). The abdominal domain was reestablished by releasing the laterally retracted abdominal wall. The amount of available abdominal wall tissue was increased by wide release of the cephalic abdominal wall fascia overlying the costal margin and the external oblique fascia and muscle laterally. If needed, partial thickness of the internal oblique muscle and its anterior fascia were also released laterally to perform a tension-free primary closure of the defect. All repairs were closed with satisfactory functional and aesthetic results. All alloplastic material was removed. Fascial release was limited so as to close only the hernia defect without tension. No significant release of the rectus sheath and muscle was needed. Good, dynamic muscle function was noted postoperatively. All repairs have remained intact, and no further abdominal wall hernias have been noted on follow-up.

Abdominal Muscles↗
PubMed1986

Massive abdominal wall desmoid tumor. Treatment by resection and abdominal wall reconstruction.

The management of a massive abdominal wall desmoid tumor in a young woman with Gardner's syndrome is discussed. Treatment options included primary radiation, subtotal excision with radiation, primary chemotherapy, or radical resection with abdominal wall reconstruction. The advantages and disadvantages of the various treatment options are discussed, and the technique of resection and reconstruction is explained.

Abdominal Muscles↗
PubMedDate not supplied

CT of abdominal wall implantation metastases after abdominal percutaneous procedures.

PURPOSE: Our goal was to report the CT manifestations of abdominal wall implantation metastases occurring after abdominal percutaneous procedure. METHOD: CT scans and clinical data of six patients with abdominal wall implantation metastases at the puncture site following abdominal percutaneous procedure were reviewed. The abdominal percutaneous procedures included drainage of intraperitoneal abscess in patients with colon or gastric cancer (n = 2), transhepatic biliary drainage in a patient with hilar cholangiocarcinoma (n = 1), biopsy of intrahepatic hepatocellular carcinoma (n = 1), biopsy of a metastatic left adrenal gland (n = 1), and laparoscopic cholecystectomy in a patient with unsuspected gallbladder cancer (n = 1). RESULTS: CT enabled the diagnosis of abdominal wall implantation metastasis in all six patients and showed coexisting intraabdominal tumor sites in five patients. All abdominal wall implantation metastases were homogeneous before intravenous administration of iodinated contrast material and became moderately heterogeneous on contrast-enhanced CT scan with marked enhancement relative to adjacent tissues. CONCLUSION: Abdominal wall implantation metastases are moderately heterogeneous on contrast-enhanced CT scan with marked enhancement relative to adjacent tissues. In most cases of abdominal wall implantation metastasis following abdominal percutaneous procedure, CT shows additional intraabdominal tumor sites. This complication may occur following a variety of abdominal percutaneous procedures (either radiological or surgical).

Abdominal Muscles↗
PubMedDate not supplied

A comparison of polypropylene mesh, expanded polytetrafluoroethylene patch and polyglycolic acid mesh for the repair of experimental abdominal wall defects.

Abdominal wall defects created in Sprague-Dawley rats were repaired with either polypropylene mesh (PPM), expanded polytetrafluoroethylene patch (PTFE) or polyglycolic acid mesh (PGA). Tensiometric studies of abdominal wall strength showed that PPM and PTFE provided a strong repair, but that the fibrous response induced by PGA was insufficient to produce a strong support for abdominal wall reconstruction. The size of the overlap at the interface between the abdominal wall fascia and prosthetic material has a greater effect on wound strength with expanded PTFE than with PPM. This is because of the different pattern of collagen infiltration into each material.

Abdominal Muscles↗
PubMed1993

Fetal abdominal wall defects.

Abdominal wall defects are frequently detected prenatally. Optimal management requires identification of the type of lesion and a careful search for associated chromosomal and structural anomalies. For cases with lethal associated abnormalities, elective termination may be offered. Preterm delivery should be considered for fetuses with gastroschisis who have evidence of ongoing intestinal damage, as evidenced by bowel dilatation and thickening, although objective selection criteria are still being developed. There is currently no convincing evidence to support routine cesarean delivery in fetuses with abdominal wall defects. Most infants with abdominal wall defects should be born at a perinatal center, where neonatal and surgical expertise is immediately available. In every case, prenatal diagnosis should lead to parental counseling and decision-making by a multidisciplinary team consisting of obstetricians, neonatologists, and pediatric surgeons.

Abdominal Muscles↗
PubMedDate not supplied

[Surgical tactics in abdominal wall neoplasia].

Abdominal wall neoplasms represent more or less 1% of human neoplasms in the adult. The authors reports their own experience based on 9 cases during over 20 years. The prognosis of these tumors is almost influenced from a lot of factors such as: histology, localization, staging, grading, sex, surgical margins, number of local recurrences. Abdominal wall neoplasm are less aggressive for compartmentalization of muscle layer and with a better prognosis because of their localization, and surgical opportunities of extensive resection (not less of 2 cm from tumor's macroscopic limits) allowed by modern prosthetic reconstruction techniques. Polipropilene seems to be the ideal material for such kind of reconstruction even if also mersilene, PTFEe and others were employed. PTFEe and Dual-meshes could be useful in those malignant tumors in which peritoneum resection is necessary.

Abdominal Neoplasms↗
PubMed2004

Component separation in the management of the difficult abdominal wall.

BACKGROUND: Abdominal compartment syndrome (ACS) and mesh implantation in abdominal wounds are creating abdominal wall problems not seen in the past. Component separation (CS) is an alternative technique used to manage these difficult wounds. METHODS: From January 2001 to July 2003, 27 patients were identified who had undergone CS. Charts were reviewed for defect etiology and characterization, surgical results, and outcome from reconstruction. RESULTS: Etiology of the defect was ACS in 14, infected mesh in 5, and multiple failed repairs in 8 patients. Twenty-three were closed completely with CS, 2 required prosthetic mesh, and 2 had a porcine implant placed. Three wound complications occurred that required reoperation. Three hernia recurrences have been identified. All patients are completely recovered and are currently functioning without limitation. CONCLUSIONS: Large and/or complex abdominal wall defects can be managed with a single-stage procedure using CS, thus many complications associated with implantation of prosthetic mesh are avoided. Functional outcome is excellent.

Abdominal Wall↗
PubMedDate not supplied

Carcinoma of sigmoid colon presenting as abdominal wall abscess.

Abdominal wall abscess is a rare presentation of intra-abdominal disease. We describe a 69-year-old woman with a locally advanced carcinoma of the sigmoid colon presenting as abdominal wall abscess. The diagnosis was suggested by computed tomography of the abdomen. She was treated with resection of the tumor with closure of the rectal stump and proximal end colostomy. No adjuvant therapy was undertaken considering the extent of the disease. She survived for four months after the operation.

Abdominal Abscess↗
PubMed1994

The use of Mitek anchors to secure mesh in abdominal wall reconstruction.

Abdominal wall complications of TRAM flap breast reconstruction are well described. Synthetic mesh abdominal reinforcement is believed to decrease the incidence of these complications. An innovative technique with commonly available suture anchors has been used in a case of recurrent abdominal laxity after a TRAM flap. Osseous fixation of synthetic mesh with the Mitek GII suture anchor will undoubtedly be used more widely in abdominal wall reconstruction.

Abdominal Muscles↗
PubMed2006

[Total abdominal wall reconstruction. Management of full-thickness losses of the abdominal wall after a long ischemic compression].

The authors report an original case of a 70-year-old male with large musculocutaneous necrosis area of the abdominal wall following a long ischemic compression. Initial treatment was done using a wide excision of the abdominal wall necrosis and insertion of synthetic prosthesis to protect bowels. After 4 weeks of further surgical revisions, two splits thickness skin grafting were performed. The grafts were placed directly on granulations around and over the mesh and the healing was complete. Postoperative course was uneventful. In our experience, this technique allowed a good cicatrisation and a good esthetical result.

Abdominal Wall↗
PubMed1984

[Plastic surgery of the abdominal wall].

An abdominal wall rich of fat or relaxed and poor of fat could be burdensome psychically and physically, especially if there are additional changes of musculoaponeurotic abdominal wall. The line of incision for abdominoplasty (cross-ellipse, anchor, star, Pitanguy) depends on age, on obesity and on private wishes of patients. In the restauration of the myoaponeurotic part the abolition of distance between the rectus muscles takes the first place. It will be followed by fastening ciatric hernias, in single cases umbilical or inguinal hernias. A considerable relaxation sometimes forces stretching of the myoapneurotic part, too. Postoperative care must be carefully, to avoid complications in wound healing and above all thromboembolism.

Abdominal Muscles↗
PubMed1996

Abdominal wall hernias.

Abdominal wall hernias are usually asymptomatic, discovered incidentally on physical examination. Emergency physicians, however, may be called on to deal with the potential life-threatening complications of abdominal wall hernias. This article discusses the anatomy, pathophysiology, and specific types of hernias in the adult and pediatric patient populations. Also covered are the complications of hernias, emergency interventions for hernia reduction, and urgent surgical consultation.

Diagnosis, Differential↗
PubMed2000

The role of tissue expansion in abdominal wall reconstruction.

Abdominal wall reconstruction of ventral hernia defects with loss of visceral domain and inadequate soft-tissue coverage presents a surgical challenge. Four patients with large, skin grafted ventral hernia defects were treated by staged abdominal wall reconstruction. During the initial stage, tissue expanders were placed under the skin and subcutaneous tissue lateral to the defects. After adequate interval expansion, the second stage was performed. The expanders were removed, the visceral contents reduced easily, and the fascia reapproximated with polypropylene mesh. The expanded skin was closed easily over the fascial repair. All four patients were reconstructed successfully without complications. Tissue expansion can restore abdominal domain and allow soft-tissue closure in complicated ventral hernia defects.

Abdominal Muscles↗
PubMed2002

Massive ventral hernias: role of tissue expansion in abdominal wall restoration following abdominal compartment syndrome.

Massive ventral hernias may result from a variety of clinical situations. One such clinical situation, a common problem in trauma patients, is abdominal compartment syndrome. Abdominal compartment syndrome frequently results in a massive abdominal defect when primary closure after surgical decompression is not possible. We offer a technique for repairing these massive ventral hernias by first expanding the lateral abdominal wall muscles, fasciae, and skin with tissue expanders and then closing the defect with elements of the "components separation" method. Additionally we present other clinical situations resulting in a massive ventral hernia that were repaired using this technique.

Abdomen↗
PubMed1979

[Reconstruction of abdominal wall defects using corium. Surgical procedure, clinical results and manometric examination of postoperative abdominal wall function].

Extensive resection of the abdominal wall was performed on six patients to reconstruct defects caused by tumors or necroses. Autologous dermis covered by a flap plasty produced good clinical and functional results, documented by the measurement of intraabdominal pressures in response to coughing, pressing, and lifting of the legs. The autologous dermis graft represents a valuable tool for the closure of large defects of the abdominal wall.

Abdominal Muscles↗
PubMed2005

Reduction of abdominal wall blood flow by clamping or carbon dioxide insufflation increases tumor growth in the abdominal wall: an experimental study in rats.

BACKGROUND: We have previously demonstrated that there is a reduction of blood flow in the abdominal wall in rats insufflated with air concomitant with an increase in tumor growth. The present study was designed to examine whether a reduction of blood flow achieved by clamping or insufflation with carbon dioxide (CO(2)) would increase tumor growth in the abdominal wall. METHODS: In the first part of the experiments, laser Doppler blood flow of both rectus muscles was measured in 16 Wistar Fu rats. The left rectus muscle was clamped to reduce blood flow, and 5 x 10(4) adenocarcinoma cells were injected into both rectus muscles. Clamping was maintained for 45 min. In the second part, 22 rats had 5 x 10(4) adenocarcinoma cells injected into the rectus muscle and blood flow was measured. The experimental group (n = 11) was insufflated with CO(2) at 10 mmHg for 45 min; the control group (n = 11) was not insufflated. After 9 days, tumor weight and volume were analyzed. RESULTS: Clamping caused a 69% reduction of blood flow (p < 0.001), whereas no reduction was registered on the nonclamped side. Tumor weight (p = 0.028) and volume (p = 0.030) were increased on the clamped side. The insufflation of CO(2) caused a 71% reduction of blood flow, whereas no reduction was registered in the control group. Tumor weight (p = 0.006) and volume (p = 0.006) were increased in the insufflated group. CONCLUSION: Clamping, as well as CO(2) insufflation, causes a significant reduction of blood flow in the abdominal wall, which seems to increase tumor growth at the same site.

Abdominal Neoplasms↗