Abdominal wall integrity after open abdomen: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM)

Hernia ◽  
2016 ◽  
Vol 20 (6) ◽  
pp. 849-858 ◽  
Author(s):  
A. Willms ◽  
S. Schaaf ◽  
R. Schwab ◽  
I. Richardsen ◽  
D. Bieler ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Wound Closure ◽  
Open Abdomen ◽  
Long Term Results

Long-Term Clinical Outcomes of an Antibiotic-Coated Non–Cross-linked Porcine Acellular Dermal Graft for Abdominal Wall Reconstruction for High-Risk and Contaminated Wounds

2021 ◽  
pp. 000313482110233
Author(s):  
Jordan Robinson ◽  
Jesse K. Sulzer ◽  
Benjamin Motz ◽  
Erin H. Baker ◽  
John B. Martinie ◽  
...  
Keyword(s):  
High Risk ◽  
Abdominal Wall ◽  
Clinical Outcomes ◽  
Open Abdomen ◽  
Abdominal Wall Reconstruction ◽  
Dermal Graft ◽  
Elective Repair ◽  
Acellular Dermal

Background Abdominal wall reconstruction in high-risk and contaminated cases remains a challenging surgical dilemma. We report long-term clinical outcomes for a rifampin-/minocycline-coated acellular dermal graft (XenMatrix™ AB) in complex abdominal wall reconstruction for patients with a prior open abdomen or contaminated wounds. Methods Patients undergoing abdominal wall reconstruction at our institution at high risk for surgical site occurrence and reconstructed with XenMatrix™ AB with intent-to-treat between 2014 and 2017 were included. Demographics, operative characteristics, and outcomes were collected. The primary outcome was hernia recurrence. The secondary outcomes included length of stay, surgical site occurrence, readmission, morbidity, and mortality. Results Twenty-two patients underwent abdominal wall reconstruction using XenMatrix™ AB during the study period. Two patients died while inpatient from progression of their comorbid diseases and were excluded. Sixty percent of patients had an open abdomen at the time of repair. All patients were from modified Ventral Hernia Working Group class 2 or 3. There were a total of four 30-day infectious complications including superficial cellulitis/fat necrosis (15%) and one intraperitoneal abscess (5%). No patients required reoperation or graft excision. Median clinical follow-up was 38.2 months with a mean of 35.2 +/− 18.5 months. Two asymptomatic recurrences and one symptomatic recurrence were noted during this period with one planning for elective repair of an eventration. Follow-up was extended by phone interview which identified no additional recurrences at a median of 45.5 and mean of 50.5 +/−12.7 months. Conclusion We present long-term outcomes for patients with high-risk and contaminated wounds who underwent abdominal wall reconstruction reinforced with XenMatrix™ AB to achieve early, permanent abdominal closure. Acceptable outcomes were noted.

Abdominal Wall Expanding System. Intraoperative Abdominal Wall Expansion as a Technique to Repair Giant Incisional Hernia and Laparostoma. New and Long-Term Results From a Three-Center Feasibility Study

2021 ◽  
pp. 155335062110414
Author(s):  
Dietmar Eucker ◽  
Nadine Rüedi ◽  
Clinton Luedtke ◽  
Oliver Stern ◽  
Henning Niebuhr ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Long Term Results ◽  
Anatomical Reconstruction ◽  
Time Saving ◽  
Lateral Abdominal Wall ◽  
Hernia Size ◽  
Midline Closure

Background The abdominal wall expanding system (AWEX) was first applied in 2012 and published in 2017. This novel technique was developed to reconstruct complex incisional hernias and residual skin-grafted laparostoma after treatment of an open abdomen, when primary midline closure was impossible. The main aim was the anatomical reconstruction of the abdominal wall and the avoidance of dissecting techniques (component separation). Methods Between 2012 and 2019, 33 patients underwent AWEX hernia repair in three certified hernia centers. The retracted abdominal wall was stretched with the AWEX system intraoperatively for approximately 30 min. Hernia size was measured preoperatively, on CT, and intraoperatively. The gain in length on the lateral abdominal wall (decrease in width of the defect) after stretching and any residual midline gap were determined in the OR. Results 33 patients underwent AWEX procedures. Six cases were evaluated separately because of additional procedures (TAR, four cases) and preoperative application of botulinum toxin (two cases). The median (95% confidence interval) measured width of hernia defects was 13 (12–16) cm, the median gain in length on the lateral abdominal wall was 12 (10–15) cm. After median follow-up of 29 (12–54) months, one recurrence from the broken mesh was observed. No method-related complications occurred. Conclusion Based on the 2017 and current results, the AWEX system represents an alternative or supplemental procedure to current techniques for complex abdominal wall reconstruction. The system proved again to be time-saving, safe, effective, and easy to learn. Further studies with enhanced technology are in progress.

Efficacy evaluation of case-specific approach for surgical treatment of incisional ventral hernia

2021 ◽  
Vol 93 (5) ◽  
pp. 1-5
Author(s):  
Svetlana Sokolova ◽  
Andrey Sherbatykh ◽  
Konstantin Tolkachev ◽  
Vladimir Beloborodov ◽  
Vadim Dulskiy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Long Term Results ◽  
Treatment Results ◽  
Specific Approach ◽  
Incisional Ventral Hernia

The Aim of research is to improve the results of surgical treatment of incisional ventral hernia by applying a case-specific approach and a new method of plastic repair of anterior abdominal wall. The prospective controlled dynamic study is based on incisional ventral hernia treatment results with the use of meshed endoprostheses among 219 patients. On-lay alloplasty was used in patients younger than 60 years of age, without severe concomitant pathology, with small and medium hernias and anterior abdominal wall defect of up to 10 cm (W1 - W2). The article shows a selection algorithm for anterior abdominal wall plastic repair method. It goes through advantages of the author’s proprietary technique. The article displays frequency and patterns of complications, life quality of the patients after various prosthetic plastic repairs. In the main group, positive treatment results were observed in 65.0%, long-term results of the operation were observed in 88.4%, complications occurred in 13.6%, relapse in 4.5%. «On lay» treatment tactics showed positive results in 59.4%, long-term results of the operation were observed in 74.7%, complications occurred in 40%, relapse in 3.1%. After «sub lay» intervention, excellent results were observed in 40.0% of patients, long-term results of the operation were observed in 81.9%, complications occurred in 12%, and relapse in 1.4%.

Comparison of the Conventional and the Ultrasound Methods of Liposuction

1995 ◽  
Vol 12 (3) ◽  
pp. 219-220 ◽  
Author(s):  
Ziya Saylan
Keyword(s):  
Abdominal Wall ◽  
Conventional Method ◽  
Recovery Time ◽  
The Other ◽  
Long Term Results ◽  
Ultrasound Method ◽  
Short Recovery Time ◽  
Conventional Methods ◽  
Very High

This article compares the results of the ultrasound and the conventional methods of liposuction and tries to determine the advantages of the ultrasound method. In comparison to the conventional method, ultrasound liposuction shows much better results in saddlebags, the abdominal wall, and the buttocks. The treatment of cellulite with ultrasound liposuction has proved to be more successful and the lift effect of the skin remains 4–6 months longer than with conventional liposuction. On the other hand, the long-term results do not show any significant differences between the two methods; we have observed equal results from both techniques after six months. Ultrasound liposuction at the knees, inner thighs, arms, and ankles has proven not to be very successful. The advantages of the ultrasound method are less pain, less bruising, less blood in the aspirate, and a short recovery time. The disadvantages are the very high expenses and the impossibility of using the aspirated fat again.

Plasty of incisional ventral hernias using a mechanical suture

1982 ◽  
Vol 63 (3) ◽  
pp. 37-40
Author(s):  
B. L. Elyashevich ◽  
F. Sh. Sharafislamov ◽  
R. M. Ramazanov
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Anterior Abdominal Wall ◽  
Long Term Results ◽  
Mechanical Suture ◽  
And Function ◽  
Ventral Hernias

Developed and applied in patients with hernias of the anterior abdominal wall a method of plasty with own tissues using a mechanical suture. 109 patients with postoperative and recurrent ventral hernias were operated on. This method of ventral hernia repair allows to restore the anatomy and function of the abdominal wall, standardizes and simplifies the technique of the operation, reducing the time of its implementation, and gives 95.4% positive long-term results.

scholarly journals Surgical Tips in Frozen Abdomen Management: Application of Coliseum Technique

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Ioannis D. Kyriazanos ◽  
Dimitrios K. Manatakis ◽  
Nikolaos Stamos ◽  
Christos Stoidis
Keyword(s):  
Abdominal Wall ◽  
Wound Closure ◽  
Open Abdomen ◽  
Clinical Pathways ◽  
Significant Proportion ◽  
Wound Dehiscence ◽  
Abdominal Organs ◽  
Management Application ◽  
Early Reconstruction ◽  
Laparotomy Incision

Wound dehiscence is a serious postoperative complication, with an incidence of 0.5–3% after primary closure of a laparotomy incision, and represents an acute mechanical failure of wound healing. Relatively recently the concept of “intentional open abdomen” was described and both clinical entities share common pathophysiological and clinical pathways (“postoperative open abdominal wall”). Although early reconstruction is the target, a significant proportion of patients will develop adhesions between abdominal viscera and the anterolateral abdominal wall, a condition widely recognized as “frozen abdomen,” where delayed wound closure appears as the only realistic alternative. We report our experience with a patient who presented with frozen abdomen after wound dehiscence due to surgical site infection and application of the “Coliseum technique” for its definitive surgical management. This novel technique represents an innovative alternative to abdominal exploration, for cases of “malignant” frozen abdomen due to peritoneal carcinomatosis. Lifting the edges of the surgical wound upwards and suspending them under traction by threads from a retractor positioned above the abdomen facilitates approach to the peritoneal cavity, optimizes exposure of intra-abdominal organs, and prevents operative injury to the innervation and blood supply of abdominal wall musculature, a crucial step for subsequent hernia repair.

scholarly journals P017 COMPLEX ABDOMINAL WALL RECONSTRUCTION IN ELDERLY PATIENTS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Joaquin Munoz-Rodriguez ◽  
Javier López Monclús ◽  
Carlos San Miguel ◽  
Luis Blázquez Hernando ◽  
Alvaro Robin Valle de Lersundi ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Surgical Site Infections ◽  
The Elderly ◽  
Long Term Results ◽  
Surgical Approaches ◽  
Preperitoneal Approach ◽  
Short And Long Term

Abstract Aim Our study aims to analyze and evaluate the results obtained in patients older than 80 years old who underwent complex abdominal wall reconstruction (CAWR) in a multicenter abdominal wall unit using different surgical approaches. Material and Methods Patients were identified from a prospective maintained multicenter database. Demographic characteristics, incisional hernias’ (IH) characteristics, as well as postoperative outcomes, including short and long-term complications have been analyzed. Results 21 patients were identified. The mean age was 82.5 (+/- 2.4) years old . There were 10 (47.6%) midline IH, 5 (23.8%) lateral IH, 4 (19%) synchronous midline and lateral IHs, and 2 (9.6%) parastomal hernias (PH). 9 (42.8%) Madrid TAR modification technique, 5 (23.8%) Rives-Stoppa, 3 (14.3%) lateral preperitoneal approaches, 1 (4.8%) midline preperitoneal approach and 1 (4.8%) anterior component separation were performed. In patients with PH, a modification of the Pauli technique (4.8%), and a unilateral TAR with a keyhole repair associated (4.8%) were performed. There were 7 (33,3) surgical site occurrences (SSO), 1 (4.8%) seroma, 3 (14.3%) hematomas and 3 (14.3%) surgical site infections. Only 3 (14.3%) SSO required procedural intervention. During a mean follow-up of 20.6 (+/- 15.9) months, 1 (4.8%) hernia recurrence was diagnosed. No cases of postoperative bulging were recorded. There were also no cases of chronic pain in the sample. During follow-up, 3 patients died from surgery unrelated causes. Conclusions CAWR in the elderly patient, after an adequate preoperatively selection of patients, presented acceptable short- and long-term results, despite the advanced population age.

scholarly journals P077 LONG-TERM CLINICAL OUTCOMES OF AN ANTIBIOTIC-COATED NON-CROSSLINKED PORCINE ACELLULAR DERMAL GRAFT IN HIGH-RISK ABDOMINAL WALL RECONSTRUCTION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Jordan Robinson ◽  
Jesse Sulzer ◽  
Erin Baker ◽  
David Iannitti
Keyword(s):  
High Risk ◽  
Abdominal Wall ◽  
Clinical Outcomes ◽  
Open Abdomen ◽  
Abdominal Wall Reconstruction ◽  
Infectious Complications ◽  
Dermal Graft ◽  
Acellular Dermal

Abstract Aim Abdominal wall reconstruction in high-risk and contaminated cases remains a challenging surgical dilemma. We report long-term clinical outcomes for a rifampin/minocycline-coated acellular dermal graft (XenMatrix™ AB) in complex abdominal wall reconstruction for patients with a prior open abdomen or contaminated wounds. Material and Methods Patients undergoing abdominal wall reconstruction at our institution at high risk for surgical site occurrence and reconstructed with XenMatrix™ AB with intent-to-treat between 2014 through 2017 were included. Demographics, operative characteristics, and outcomes were collected. Primary outcome was hernia recurrence. Secondary outcomes included length of stay, surgical site occurrence, readmission, morbidity, and mortality. Results Twenty-two patients underwent abdominal wall reconstruction using XenMatrix™ AB during the study period. Two patients died while inpatient from progression of their comorbid diseases and were excluded. Sixty percent of patients had an open abdomen at time of repair. All patients were Modified VHWG class 2 or 3. There was a total of four 30-day infectious complications including superficial cellulitis/fat necrosis (15%) and one intraperitoneal abscess (5%). No patients required re-operation or graft excision. Median clinical follow-up was 35.1 months with a mean of 32.2 +/- 16.5 months. Two asymptomatic recurrences and one symptomatic recurrence were noted during this period. Follow-up was extended by phone interview which identified no additional recurrences at a median of 45.5 and mean of 50.5 +/-12.7 months. Conclusions We present long-term outcomes for patients with high-risk and contaminated wounds who underwent abdominal wall reconstruction reinforced with XenMatrix™ AB to achieve early, permanent abdominal closure. Acceptable outcomes were noted.

Sign in / Sign up

Export Citation Format

Share Document