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At least 757 records · Page 42Linked to original sources
PubMed1998

The effect of full-thickness abdominal wall burns sustained during childhood on subsequent childbearing ability.

The effect of full-thickness burns of the abdomen during childhood on subsequent pregnancy was evaluated. Eight hundred female pediatric patients treated for acute burns during a 14-year period (1975-1989) at the Shriners Burns Institute were reviewed. Through a combination of clinical follow-up, questionnaires, or phone interviews, data were obtained regarding the histories of 31 pregnancies in 19 patients who had required excision and skin grafting of > or = 50% of their abdominal wall during management of their acute burns. These patients sustained a mean burn size of 59.8% total body surface area (TBSA; range, 23-87%) with a mean full-thickness burn of 43.8% TBSA (range, 10-78%). The mean age at the time of burn was 7.6 years (range, 1.5-15 years). Normal rates of vaginal and cesarean section deliveries, prematurity, and infant mortality were observed in these 31 pregnancies. Despite a subjective sensation of increased tension on the scar in 25% of the patients, no interference with these patients carrying a full-term pregnancy directly attributable to the burn scar was identified. Follow-up and examination during the third trimester of pregnancy demonstrated how the burned and unburned portion of the abdominal wall accommodated the enlarged uterus. This review demonstrates that after extensive burns to the abdomen, which have been treated with excision and skin grafting during childhood, the scarred abdominal wall accommodates full-term pregnancy without the need for surgical release.

Abdominal Injuries↗
PubMed1991

Xiphoomphaloischiopagus tripus conjoined twins: successful separation following abdominal wall expansion.

A case of xiphoomphaloischiopagus tripus conjoined twins is reported. Particular emphasis was paid to the large abdominal wall defect that would be produced by separation, and the complications resulting from the use of intraperitoneal Silastic tissue expanders are described. As a result of adequate tissue expansion and the use of a vascularized pedicle graft from the fused limb, primary abdominal wall and pelvic closure was possible without complications of wound healing. The consistent finding of a shared lower urinary tract with one ureter from each infant entering each bladder should be anticipated in this type of twinning.

Abdominal Muscles↗
PubMed1993

[Surgical repair of large defects in the abdominal wall with biosynthetic prosthesis].

The article discusses the results of surgical management of postoperative and posttraumatic hernias with large defects in the anterior abdominal wall in 66 patients. In 56 (80.2%) patients the defect in the abdominal wall measured more than 400 cm2 (20 cm in diameter). The authors developed a method for closure of the defect with a 2-3-layer biosynthetic prosthesis without reducing the volume of the abdominal cavity. The lower layer of the prosthesis is formed by a biological tissue which is covered in sequence with synthetic prostheses (layers) with an increasing destruction period. The authors claim that the method does not require prolonged preoperative management for the prevention of cardiopulmonary and gastrointestinal complications because it supposes maintenance of the optimal volume of the abdominal cavity. No complications on the part of the respiratory organs and disorders of gastrointestinal activity were encountered in the early postoperative period. Peripheral necrosis of the skin occurred in 7 patients, accumulation of serous fluid was encountered in 4 cases and a ligature fistula in one case. The late-term results were studied in 60 patients in follow-up periods of 12 months to 5 years. Recurrent hernias were not found.

Abdominal Muscles↗
PubMed2002

How should an infected perinephric haematoma be drained in a tetraplegic patient with baclofen pump implanted in the abdominal wall? - A case report.

BACKGROUND: We present a case to illustrate controversies in percutaneous drainage of infected, perinephric haematoma in a tetraplegic patient, who had implantation of baclofen pump in anterior abdominal wall on the same side as perinephric haematoma. CASE PRESENTATION: A 56-year-old male with C-4 tetraplegia had undergone implantation of programmable pump in the anterior abdominal wall for intrathecal infusion of baclofen to control spasticity. He developed perinephric haematoma while he was taking warfarin as prophylactic for deep vein thrombosis. Perinephric haematoma became infected with a resistant strain of Pseudomonas aeruginosa, and required percutaneous drainage. Positioning this patient on his abdomen without anaesthesia, for insertion of a catheter from behind, was not a realistic option. Administration of general anaesthesia in this patient in the radiology department would have been hazardous. RESULTS AND CONCLUSION: Percutaneous drainage was carried out by anterior approach under propofol sedation. The site of entry of percutaneous catheter was close to cephalic end of baclofen pump. By carrying out drainage from anterior approach, and by keeping this catheter for ten weeks, we took a risk of causing infection of the baclofen pump site, and baclofen pump with a resistant strain of Pseudomonas aeruginosa. The alternative method would have been to anaesthetise the patient and position him prone for percutaneous drainage of perinephric collection from behind. This would have ensured that the drainage track was far away from the baclofen pump with minimal risk of infection of baclofen pump, but at the cost of incurring respiratory complications in a tetraplegic subject.

Abdominal Wall↗
PubMed1998

Development of a novel synthetic material to close abdominal wall defects.

To compare the efficacy of a novel synthetic material (TMS-2) with polytetrafluoroethylene, polypropylene (Marlex), and primary closure of experimentally fashioned clean and contaminated abdominal wounds, 1-cm2 abdominal wall defects were created in each of the four abdominal quadrants of rats (n = 10). Patches of each material were used to repair three of these defects, the fourth being primarily closed. A second group of rats (n = 7) underwent the same operative protocol; however, peritonitis was induced at the time of surgery using a fecal inoculation technique. Animals were killed 2 weeks later, and surface area and severity of formed adhesions were assessed by a "blinded" observer. All closure techniques were successful insofar as none demonstrated fascial dehiscence. Compared with each synthetic material, the surface area of formed adhesions was smaller after primary closure in clean and in contaminated conditions; however, the three synthetic materials were equally matched regarding surface area of adhesions under both conditions. In the face of fecal contamination, TMS-2 proved identical to primary closure, each generating significantly (P < 0.02) milder adhesions than the other prosthetic materials. It is concluded that the TMS-2 may prove of clinical benefit to repair abdominal wall defects.

Abdominal Muscles↗
PubMed1994

Abdominal wall hernias in ESRD patients receiving peritoneal dialysis.

The study was designed to investigate the incidence of abdominal wall hernias (AWH) and related outcome in all end-stage renal disease (ESRD) patients who started peritoneal dialysis (PD) from January 1989 to December 1993. Between January 1989 and December 1993, a total of 158 ESRD patients (93 male, 65 female) entered our home program and were treated with peritoneal dialysis (PD) over 2789 patient-months. All PD catheters were placed in the lateral by two dedicated surgeons. AWH detected at the time of PD catheter placement was repaired simultaneously. The hernia repair was done using a polypropylene mesh. Inguinal hernias were noted by patients as a mass or discomfort. Umbilical and incisional hernias were observed during clinic visits. Twenty-one (13.3%) abdominal wall hernias were observed in 20 patients (12.7%). Eight (38.1%) inguinal hernias occurred in 8 male patients. Six inguinal hernias were repaired. PD was resumed after a mean of 12 days of hernia repair. Two patients resumed PD in 8 and 14 days without dialysis. One patient transferred to hemodialysis (HD) due to catheter malfunction. No complications occurred related to inguinal hernias. Ten (47.6%) umbilical hernias were observed in 10 patients (7 male, 3 female). The strangulation of umbilical hernias occurred in 2 patients, which required emergency small bowel resection and hernia repair. Both cases were complicated by candida peritonitis and enterobacter peritonitis, requiring PD catheter removal, and patients were then transferred to HD. Three (14.3%) incisional hernias were observed in 3 male patients. Two incisional hernias were repaired. No relation between AWH and PD modalities (CAPD/CCPD/IPD) was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1987

[A case of extensive defect of the abdominal wall treated surgically by implanting the Dallop fascial prosthesis].

A patient is described with an advanced tumor of the abdominal wall 15 x 10.5 x 10 cm in size, which grew into the left liver lobe and the transverse colon. The altered tissues were resected along with a wide margin of surrounding tissues. The defect in the abdominal wall was covered by the Dallop fascia prosthesis. There were reported no complications in the postoperative period.

Abdominal Muscles↗
PubMed1983

Teratogenic aspects of abdominal wall defects.

The article describes two methods used to reveal possible teratogenic factors involved in the aetiology of abdominal wall defects. Forty-six mothers to children with gastroschisis and omphalocele were questioned about heredity, occupation, use of drugs etc. during early pregnancy (case history study). Seventy-four mothers to children with gastroschisis and omphalocele were randomly selected from a national register and their maternal health service record forms were studied and compared with the forms of 144 matched controls (case control study). None of the analyzed factors was found to be of significant teratogenic importance in the aetiology of abdominal wall defects, nor was it possible to explain the increase in the incidence of gastroschisis taking place during the early 70s.

Abdominal Muscles↗
PubMed1991

Short-term and long-term problems after duraplastic enlargement of anterior abdominal wall.

Between 1974 and 1989, 49 out of 83 children with gastroschisis or omphalocele underwent duraplastic enlargement of the anterior abdominal wall. The solvent dried dura proved to be the most useful material, which could be left in place even after a scar had formed. Abdominal complications depend on preexisting damage of the intestine and on the intraabdominal pressure resulting from closure. Long-term disturbances of the gastrointestinal and abdominal wall function are comparable to the results of other reconstructive methods.

Abdominal Muscles↗
PubMed1988

[A surgical method of abdominal wall reconstruction in prune belly syndrome].

The "Prune Belly"-syndrome consists of a triad of anomalies: absence or hypoplastic musculature of the abdominal wall, bilateral cryptorchidism, and dilatation of the urinary tract. A surgical method of construction of the abdominal wall in such a case with a missing rectus abdominis is reported.

Abdominal Muscles↗
PubMed1997

A novel method for induction and detection of anaphylactic reaction using the mouse abdominal wall (AW method).

We found that an antigen-specific anaphylaxis was induced by antigen challenge to the abdominal wall, ear auricle, or subcutaneous tissue in mice sensitized 9 days previously with antigen and adjuvant. The anaphylactic reaction was detected by vascular permeability at the injected site 7 minutes after challenge, which was the best time for estimation. A novel method (AW method) for induction and detection of the anaphylactic reaction in mice was established using the abdominal wall as the challenge site. This method could detect the anaphylactic response in mice 1 to 3 weeks after sensitization. The increase in vascular permeability was completely inhibited by administration of diphenhydramine.

Abdominal Muscles↗
PubMed1989

Dura versus Gore-Tex as an abdominal wall prosthesis in an open and closed infected model.

Occasionally, it is necessary to use prosthetic material to close large abdominal wall defects in infected, potentially infected, or open wounds. We compared the effectiveness of Gore-Tex (PTFE, W.L. Gore & Associates, Flagstaff, AZ) and dura for closing large, full thickness abdominal wall defects in terms of resistance to infection, patch separation, and intraperitoneal adhesion formation. Ninety guinea pigs had full thickness, 2 cm2, abdominal defects patched with either PTFE or dura. The skin was (A) left open (B) closed over the patch under aseptic conditions, or (C) closed after wound contamination with 10(5) CFU of staphylococcus aureus. Wounds were examined daily and the wound and peritoneal cavity examined at necropsy (day 45). Patch separation, patch retention, and adhesions were similar in both open (A), and clean closed (B) wounds patched with PTFE or dura. In the infected closed wounds (C) of the PTFE animals, the incision remained intact significantly longer, the time of patch separation and overall patch retention were significantly increased, and bowel adhesions were significantly reduced compared to dura animals.

Abdominal Muscles↗
PubMed2006

Use of regenerative human acellular tissue (AlloDerm) to reconstruct the abdominal wall following pedicle TRAM flap breast reconstruction surgery.

BACKGROUND: Harvest of transverse rectus abdominis musculocutaneous (TRAM) flaps for breast reconstruction leaves a variable defect in the anterior rectus fascia. Inadequate closure of the defect could lead to the development of hernia or abdominal wall bulging. Various techniques have been developed to reduce the incidence of hernia and abdominal wall bulging. The authors describe a novel technique of using a regenerative human acellular matrix (AlloDerm) as a fascial substitute in closing the defect. METHODS: Fifty-four consecutive patients who opted for pedicle TRAM flap procedures for breast reconstruction postmastectomy were scheduled for donor-site repair with the use of AlloDerm. AlloDerm was placed interpositionally as an inlay graft to mimic the anterior rectus fascia. RESULTS: Hernia or infection did not develop in any of the patients. There was a greater incidence of seroma and bulging among the first 18 patients, with eight seromas (44.4 percent) and six bulges (33.3 percent). When the technique was ameliorated in the next 36 patients, there was a reduction in the incidence of seromas (16.7 percent, p = 0.03) and bulges (16.7 percent, p = 0.17). Of the three patients who experienced wound dehiscence, partial AlloDerm exposure occurred in two, but was resolved without further consequences. Biopsy specimens of AlloDerm, obtained 12 and 14 months after TRAM donor-site repair, showed full tissue integration. The cell density, vasculature, and collagen orientation in the biopsies were consistent with abdominal fascia tissue. CONCLUSION: Based on these results, the authors recommend the use of AlloDerm as an alternative option for abdominal fascia closure after TRAM flap harvest for breast reconstruction.

Abdominal Wall↗
PubMed1991

TFE-plasma polymerized dermal sheep collagen for the repair of abdominal wall defects.

The aim of this study was to design and evaluate a degradable biomaterial for the repair of abdominal wall defects. Hexamethylenediisocyanate-tanned dermal sheep collagen (HDSC) was plasma-polymerized with tetrafluoroethylene (TFE) which resulted in a hydrophobic surface on the visceral side (TFE-HDSC). Full-thickness abdominal wall defects were made in rats and repaired with HDSC or TFE-HDSC implants. Unmodified HDSC implants showed excellent fixation to the adjacent muscle tissue but intestinal adhesions were observed. These implants showed insufficient strength after four weeks, illustrated by bulging of the peritoneal contents (herniation). Plasma-polymerized implants after four weeks of implantation showed firm incorporation into the surrounding muscle tissue. With one exception there were no bowel adhesions. Fewer herniations were observed, indicating a prolonged degradation period. Further studies on the optimalization of degradation time are in progress.

Abdominal Muscles↗
PubMed1996

Repair of transversely incised abdominal wall fascia in a rabbit model.

OBJECTIVE: To compare several commonly used methods of closing transversely incised anterior abdominal wall in order to determine which technique results in the strongest incisional tensile strength. METHODS: Thirty-six rabbits were randomized to receive either interrupted or continuous closure with 0-Vicryl. Within these groups, each animal was randomized to one of three different bite and interval techniques: 1-cm bites/0.5-cm intervals, 1-cm bites/1-cm intervals, and 2-cm bites/1-cm intervals. Each rabbit received three to four transverse abdominal wall incisions of approximately 3-8 cm in length. The incisions were excised en bloc and stored at -70C at postoperative week 1, 2, or 4 in a random fashion. Representative 1-cm strips were harvested from each incision after thawing. The Instron tensiometer was used to determine the maximum intrinsic tensile strength required to disrupt each tissue strip at the incision. Statistical analysis was performed using analysis of variance, two-sample t test, Scheffé multiple comparison, and Kruskal-Wallis test. RESULTS: Two hundred thirty-seven strips were analyzed. The mean maximum tensile strength of all of the interrupted and continuous suture repairs was 48 and 38 lb, respectively (P < .001). The maximum tensile strength for interrupted closures was achieved at week 1 and was similar at week 4. The continuous closure was weakest at week 1 and increased to a maximum value during week 4. There was no difference in maximum tensile strength between the interrupted and continuous closure groups at week 4. There was no significant difference in the maximum tensile strength of the three repair techniques. The mean maximum tensile strength of all specimens was significantly less among those harvested during weeks 1 and 2 compared with week 4 (P = .001). CONCLUSION: In this randomized study, the interrupted closure had a greater maximum tensile strength than the continuous closure in repair of transverse incisions during the first 2 postoperative weeks. Both repair methods were associated with a similar maximum tensile strength at 4 postoperative weeks. Repair techniques using different bite sizes and intervals resulted in similar maximum tensile strengths.

Abdominal Muscles↗