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At least 685 records · Page 38Linked to original sources
PubMed2006

Effect of paralysis of the abdominal wall muscles by botulinum A toxin to intraabdominal pressure: an experimental study.

PURPOSE: To show the effect of botulinum A toxin-induced paralysis of abdominal muscles on intraabdominal pressure. MATERIAL AND METHODS: Fifteen Sprague-Dawley rats were divided into 2 groups. An abdominal skin incision was done, and 2 catheters were placed for the pressure monitoring and saline infusion. Saline solution was given to the abdomen until reaching to a pressure level of 9 cm H2O and 6 mm Hg in pressure device, and the amounts of injected saline were recorded. Then intraabdominal saline was drained. Two milliliters (5 U/mL) botulinum A toxin was applied to the abdominal muscles in group 2. Saline was injected at the same points in same amounts in group 1. After 3 days, catheters were placed, and the saline volumes needed to obtain the same pressure levels were recorded for each rat. Spontaneous motor unit potential (MUP), single MUP analysis and interference patterns of the muscles, respiratory rates, and vascular pressure measurements were recorded before and after botulinum toxin (Botox) injections. RESULTS: Mean intraabdominal saline volumes in the first and third days were 63.8 and 64.4 mL in group 1 and 67.6 and 80.6 mL in group 2, respectively. Mean MUP amplitude and duration of the rectus muscles in group 2 (17.1 microV and 1.47 milliseconds) were significantly lower than those of group 1 (187 microV and 4.9 milliseconds) in the third day. There were no pathological changes in respiratory rates and pressure measurements before and after Botox injections. CONCLUSION: This pilot experimental study showed that local injection of botulinum A toxin causes paralysis in abdominal wall muscles, increases the intraabdominal volume, and decreases the pressure, and this application may be used as an adjunct in abdominal wall closure in selective cases.

Abdominal Wall↗
PubMed2001

Challenging abdominal wall defects.

BACKGROUND: We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS: The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with massive fascial defects and closed wounds. They were reconstructed with autogenous tissue using either the separation of parts (SOP) procedure or free tensor fascia lata (TFL) grafts. Group 2 patients had fascial defects with open wounds. Wound closure was first accomplished with either STSG or primary skin closure over viscera. These patients, now "converted" into patients with closed wounds, were reconstructed months later as in group 1. RESULTS: Average defect size was 320 cm2. Wound closure was achieved in one procedure in all patients with open wounds. Time to discharge after this procedure averaged 9 days. The only morbidity of wound closure was skin graft donor site pain. Average time from temporary staged closure with skin grafts to definitive closure with autogenous tissue was 5 months. Repair of closed fascial defects with autogenous tissue was performed in 51 patients. Average time to discharge after autogenous tissue repair was 6.6 days. Recurrence of hernia was noted in 2 (3.9%) patients with an average follow-up of 24 months. CONCLUSIONS: Treatment of challenging abdominal wall defects can be accomplished simply and safely utilizing the above surgical algorithm. Open wounds are converted into closed wounds and fascial defects are repaired with autogenous tissue. This treatment plan has proved to be effective in a wide variety of situations.

Abdominal Injuries↗
PubMed1997

Cardiorespiratory changes during gynaecological laparoscopy by abdominal wall elevation: comparison with carbon dioxide pneumoperitoneum.

We have studied the cardiorespiratory changes produced by abdominal wall elevation (AWE) or carbon dioxide pneumoperitoneum (PN) in 20 women undergoing gynaecological laparoscopy. Arterial pressure, heart rate, lung/chest complicance and blood-gas tensions were measured 10 min after induction of general anaesthesia (T0), 10 min after abdominal distension in the supine position (T1) and 10 min after the Trendelenburg position was assumed (T2). Visual analogue scores for pain were recorded 1 and 6 h after the end of surgery. We found that lung/chest compliance was reduced significantly in group PN at T1 and T2 compared with both T0 and group AWE. Diastolic arterial pressure increased significantly in group PN at T1 and T2 compared with both T0 and group AWE, while it remained unchanged in group AWE. Arterial PCO2 increased significantly only in group PN after pneumoperitoneum, while oxygenation was almost unchanged in both groups. AWE patients had greater abdominal pain 1 h after surgery. Six hours after surgery pain was similar in the two groups. These data indicate that abdominal wall elevation reduced pulmonary compliance less than a pneumoperitoneum in patients undergoing gynaecological laparoscopy.

Abdominal Muscles↗
PubMed1992

Comparison of strategies for preventing abdominal-wall weakness after TRAM flap breast reconstruction.

To determine the best method for preserving abdominal-wall integrity after TRAM flap breast reconstruction, the records of 130 patients followed for at least 6 months (mean 18 months) were examined. Three strategies for management of the abdominal-wall repair were compared. In the first group (72 patients), the entire width of the rectus abdominis muscle was harvested with the flap, and the anterior rectus sheath was closed in one layer. In the second group (20 patients), only the medial two-thirds of the rectus abdominis muscle was removed from the abdomen. The muscle and fascial donor defects were closed in separate layers. In the third group (38 patients), only one-fifth of the muscle was preserved, and a two-layered fascial closure of the anterior rectus sheath was performed, emphasizing repair of the internal oblique fascia to the midline fascia deep to the linea alba. Reinforcing synthetic mesh was used (in 10 patients) if closure was difficult or sutures tended to pull through the fascia. The incidence of abdominal weakness and/or bulging was similar in the first two groups (33 and 40 percent, respectively), but significantly lower (8 percent) in the third group (p = 0.006).

Abdominal Muscles↗
PubMed1982

The reconstruction of defects of the abdominal wall with split thickness skin grafts.

In our series, large, full thickness defects of the abdominal wall, resulting from debridement for fasciitis, were not primarily closed. Defects were treated open with topical applications and nutritional support. From seven to 20 days from the onset of treatment, exposed viscera were densely adhered with granulation tissue upon which skin grafts could be placed. For large abdominal wall defects which cannot be primarily closed, this technique is safe and functioning satisfactorily.

Abdominal Muscles↗
PubMed1995

[Hematoma of the abdominal wall as differential diagnosis of cystic pelvic tumor].

In a woman patient aged 80 years under anticoagulation with dicumarol (Marcumar), abdominal pain suddenly occurred which was located on the right side as well as signs of acute bleeding. Preoperative sonography and computer scan showed a large, cystic tumour, most likely originating from the right ovary with infiltration of the abdominal wall. Intraoperative diagnosis was a large haematoma of the abdominal wall and the retroperitoneum penetrating into the free abdomen.

Abdominal Muscles↗
PubMed1991

Measurements of ultrasonic pulse arrival time differences produced by abdominal wall specimens.

The influence of propagation medium inhomogeneities on pulsatile ultrasonic fields has been investigated experimentally. The study employed a special curved transducer to produce a hemispherical wave pulse and a linear array to measure the resulting field along a line in a plane. Translation of the array in the elevation direction yielded data over a two-dimensional aperture. Time delay across the aperture was calculated by adding delay differences obtained by cross-correlating signals on adjacent elements and noting the position of the cross-correlation peaks. Received waveforms were shifted an amount given by the difference between the actual arrival time and a calculated geometric delay to isolate arrival time differences due to propagation path inhomogeneities. Waveform and time delay difference plots as well as histograms and statistics derived from them for propagation through a water path and for propagation through five specimens of human abdominal wall indicate that arrival time fluctuations in the presence of human abdominal wall specimens are significantly greater than for a water path and that degradation in focusing through human abdominal wall can be expected in ultrasonic imaging systems that operate in the low megahertz range and employ a relatively large aperture.

Abdominal Muscles↗
PubMed2005

Peritoneal regeneration induced by an acellular bovine pericardial patch in the repair of abdominal wall defects.

BACKGROUND: This study was to evaluate the feasibility of using an acellular bovine pericardium fixed with genipin (AGP) to repair an abdominal wall defect created in a rat model. MATERIALS AND METHODS: The glutaraldehyde-fixed acellular pericardium (AGA), the genipin-fixed cellular pericardium (GP), and a commercially available polypropylene mesh were used as controls. RESULTS: Gross examination at 3-month post-operatively revealed that dense adhesions to the visceral organs were observed for the polypropylene mesh and the AGA patch, while a filmy to dense adhesion was seen for the GP patch. In contrast, no adhesion to the visceral organs was observed for the AGP patch. Histologically, inflammatory cells were found mainly surrounding the GP patch. In contrast, host cells (inflammatory cells, fibroblasts, and neo-capillaries) were able to infiltrate into the AGA and AGP patches. Unlike the AGA patch, the AGP patch retrieved at 1-month post-operatively became well integrated with the host tissue near the suture line. Additionally, there were some mesothelial cells, identified by the van Gieson stain, observed on the AGP patch. At 3-month post-operatively, a neo-peritoneum was observed on the AGP patch. The neo-peritoneum consisted of organized vascularized connective tissues covered by an intact layer of mesothelial cells. The calcium contents of the polypropylene mesh and the AGA patch increased significantly at 3-month post-operatively, while those of the GP and AGP patches stayed minimal throughout the entire course of the study. CONCLUSIONS: The results obtained in the study revealed that the AGP patch effectively repaired abdominal wall defects in rats and successfully prevented the formation of post-surgical abdominal adhesions.

Abdomen↗
PubMed1980

Malignant soft-tissue tumors of the anterior abdominal wall.

A clinicopathologic study was made of 32 soft-tissue sarcomas of the anterior abdominal wall (ten desmoid tumors and 22 fully malignant sarcomas). Direct invasion of the costal margin or the iliac crest was observed in both types, whereas transperitoneal invasion and metastasis developed characteristically with fully malignant sarcomas. Wide monobloc resection of the abdominal wall, including, where necessary, resection of adjacent bony parts and reconstruction with a prosthetic mesh, satisfactorily controlled local disease in nine of ten patients with desmoid tumor, and in three of four patients with primary operable, fully malignant sarcoma. Adjunctive therapy with radiation and chemotherapy may improve the outcome in patients with recurrent or high-grade sarcomas, but adequate monobloc resection of the primary tumor remains the most important therapeutic objective.

Abdominal Muscles↗
PubMed1995

[Defects of the anterior abdominal wall--their prenatal management].

The rate of the congenital malformations: gastroschisis and omphalocele, the prenatal management and the clinical issue were analyzed in a retrospective study during a period from January 1990 till October 1994 in the State Maternity Hospital "Maĭchin dom". The aim of the study was to establish the accuracy of the prenatal sonographic diagnosis of the defects of abdominal wall, the gestational age they were found out, and the perinatal issue of the affected newborn infants. The rate of the abdominal walls defects was 1:1525. They were diagnosed prenatally in 52% of the cases. The fatality rate among the alive-born infants with these malformations was 77%. The frequency of the associated anomalies with defects of the abdominal wall was 71%, which exceeds the mean frequency in Europe and presents one of the most important factors determining the high fatality rate.

Abdominal Muscles↗
PubMed1997

Harmonic amplitude distribution in a wideband ultrasonic wavefront after propagation through human abdominal wall and breast specimens.

The amplitude characteristics of ultrasonic wavefront distortion produced by transmission through the abdominal wall and breast is described. Ultrasonic pulses were recorded in a two-dimensional aperture after transmission through specimens of abdominal wall or breast. After the pulse arrival times were corrected for geometric path differences, the pulses were temporally Fourier transformed and two-dimensional maps of harmonic amplitudes in the measurement aperture were computed. The results indicate that, as the temporal frequency increases, the fluctuation in harmonic amplitudes increases but the spatial scale of the fluctuation decreases. The normalized second-order and third-order moments of the amplitude distribution also increase with temporal frequency. The wide range variation of these distribution characteristics could not be covered by the Rayleigh, Rician, or K-distribution because of their limited flexibility. However, the Weibull distribution and especially the generalized K-distribution provide better fits to the data. In the fit of the generalized K-distribution, a decrease of its parameter alpha with increasing temporal frequency was observed, as predicted by analysis based on a phase screen model.

Abdomen↗
PubMed1996

Repair of laparoscopic injury to abdominal wall arteries complicated by cutaneous necrosis.

Operative laparoscopic techniques requiring placement of large-bore cannulas through the abdominal wall lateral to the midline result in increased numbers of injuries to abdominal wall vessels. Five cases of inferior epigastric artery hemorrhage were controlled by percutaneous transabdominal placement of polypropylene sutures, allowing the procedure to be completed with the cannula in place. In two patients the sutures were left in place for 72 to 96 hours, and cutaneous necrosis occurred requiring debridement and delayed primary closure. In the other three women, removal of the sutures less than 24 hours postoperatively resulted in satisfactory hemostasis and primary healing of the abdominal wound. Percutaneous placement of polypropylene sutures may provide effective hemostasis after inferior epigastric artery hemorrhage due to cannula injury. Early suture removal may avoid potential cutaneous necrosis.

Abdominal Muscles↗
PubMed1979

[Lymphatic bed of layers of the abdominal wall in the human inguinal area].

Lymphatic bed in the layers of the inguinal area was studied in connection with age in 70 human corpses. Polychromic injection of arteries, veins and lymphatic bed, staining of preparations after van Gieson, Weigert, with hematoxylin-eosin and morphometry were the methods applied. It was stated that lymphatic capillaries penetrate through all the layers forming the abdominal wall of the human inguinal area; they arrange interconnected networks in dermis, in external and internal oblique and transversal muscles and in their aponeuroses, as well as in fasciae and in the peritoneum. The lymphatic bed in question changes during ontogenesis. Age transformations of the lymphatic capillaries are in connection with functional loading on the anterior abdominal wall. Intraorganic connections existing between the lymphatic vessels of the anterior abdominal wall and the organs of the small pelvis (urinary bladder, uterus, rectum, etc.) are revealed, they are of a rather great interest for physicians.

Abdominal Muscles↗
PubMed1994

[Comparison of intraoperative complications between laparoscopic cholecystectomy by intraperitoneal insufflation and abdominal wall lifting].

We compared intraoperative circulatory and respiratory complications and changes in body temperature during laparoscopic cholecystectomy by intraperitoneal insufflation of carbon dioxide gas (24 cases) with those by abdominal wall lifting (16 cases). The abdominal wall lifting method tended to produce fewer complications than the intraperitoneal insufflation method, but not significantly. In conclusion, the former was thought to be safer than the latter.

Abdominal Muscles↗
PubMed2003

Changes in muscle strength and pain in response to surgical repair of posterior abdominal wall disruption followed by rehabilitation.

BACKGROUND: Posterior abdominal wall deficiency (PAWD) is a tear in the external oblique aponeurosis or the conjoint tendon causing a posterior wall defect at the medial end of the inguinal canal. It is often known as sportsman's hernia and is believed to be caused by repetitive stress. OBJECTIVE: To assess lower limb and abdominal muscle strength of patients with PAWD before intervention compared with matched controls; to evaluate any changes following surgical repair and rehabilitation. METHODS: Sixteen subjects were assessed using a questionnaire, isokinetic testing of the lower limb strength, and pressure biofeedback testing of the abdominals. After surgery and a six week rehabilitation programme, the subjects were re-evaluated. A control group were assessed using the same procedure. RESULTS: Quadriceps and hamstrings strength was not affected by this condition. A deficit hip muscle strength was found on the affected limb before surgery, which was significant for the hip flexors (p = 0.05). Before surgery, 87% of the patients compared with 20% of the controls failed the abdominal obliques test. Both the injured and non-injured sides had improved significantly in strength after surgery and rehabilitation. The strength of the abdominal obliques showed the most significant improvement over the course of the rehabilitation programme. CONCLUSIONS: Lower limb muscle strength may have been reduced as the result of disuse atrophy or pain inhibition. Abdominal oblique strength was deficient in the injured patients and this compromises rotational control of the pelvis. More sensitive investigations (such as electromyography) are needed to assess the link between abdominal oblique function and groin injury.

Abdominal Muscles↗
PubMedDate not supplied

Comparison of meshes for the repair of experimental abdominal wall defects.

The aim of this experimental study was to compare the effects of polytetrafluoroethylene patch, polypropylene mesh, and porcine dermal collagen implant in rats for the repair of abdominal wall defects. We created experimental abdominal wall defects in 45 rats (three groups of fifteen) and repaired them with polytetrafluoroethylene, polypropylene mesh, and porcine dermal collagen implant by onlay technique. We sacrificed 4 rats from each group at 4, 8, 10, and 12 weeks after implantation and observed if hernia, adhesion, effusion, or infection occurred. We measured the tensile strengths of meshes by a digital tensometer. We made histological and electron microscopic evaluations of the meshes. Postoperative infection and effusion occurred in one rat in each group. Hernia was not found throughout the trial. The tensile strength of polytetrafluoroethylene patch and polypropylene mesh increased more than porcine dermal collagen implant until the end of week 12. Adhesion formation was minimal in the porcine dermal collagen group and moderate in the polytetrafluoroethylene patch and polypropylene mesh groups. Polytetrafluoroethylene patch showed minimum absorption and maximum foreign body reaction. Our results show that although none of the material reached the criteria of ideal mesh, polypropylene mesh is the better mesh for the repair of abdominal defects. Polytetrafluoroethylene patch though expensive, can also be used as a reliable mesh. We do not advise porcine dermal collagen implant as a mesh for abdominal defects due to its weak structure.

Abdominal Muscles↗