Anterior Abdominal Wall Defect Closed by the Anterior Sheath of the Upper Rectus Abdominis Muscle in a Patient with Prior “TRAM Flap Breast Reconstruction”

2021 ◽  
Author(s):  
Kuo Chen ◽  
Narasimha M. Beeraka ◽  
Jingruo Li ◽  
Pengwei Lu
Keyword(s):  
Breast Reconstruction ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Rectus Abdominis ◽  
Tram Flap ◽  
Rectus Abdominis Muscle ◽  
Wall Defect

scholarly journals Rectus Abdominis Muscle Malignant Fibrous Histiocytoma Causing a Large Abdominal Wall Defect: Reconstruction with Biological Mesh

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Evangelos Falidas ◽  
Stavros Gourgiotis ◽  
Christina Goudeli ◽  
Stavros Mathioulakis ◽  
Konstantinos Vlachos ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Abdominal Wall ◽  
Malignant Fibrous Histiocytoma ◽  
Fibrous Histiocytoma ◽  
Abdominal Wall Defect ◽  
Biological Mesh ◽  
Rectus Abdominis ◽  
Abdominal Wall Defects ◽  
Rectus Abdominis Muscle ◽  
Wall Defect

Malignant fibrous histiocytoma (MFH) is a common soft tissue sarcoma usually involving limbs and retroperitoneum. MFH of the rectus abdominis muscle is extremely rare. Surgery in similar cases leads to large abdominal wall defects needing reconstruction. Biological and synthetic laminar absorbable prostheses are available for the repair of hernia defects in the abdominal wall. They share the important feature of being gradually degraded in the host, resulting the formation of a neotissue. We herein report the case of an 84-year-old man with MFH of the rectus abdominis muscle which was resected and the large abdominal wall defect was successfully repaired with a biological mesh.

scholarly journals Cadaver as an experimental a model for the study of midline incisional hernia

2011 ◽  
Vol 26 (4) ◽  
pp. 310-313 ◽  
Author(s):  
Romar Ângelo Barbato Silveira ◽  
Fábio Xerfan Nahas ◽  
Bernardo Hochman ◽  
Felix Carlos Ocariz Bazzano ◽  
Carlos Roberto Amorim ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Tensile Force ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Wall Defect ◽  
Linea Alba ◽  
Force Application ◽  
Tensile Forces

PURPOSE: To describe a cadaver model and to compare different techniques to correct midline incisional hernia using the tension at the musculoaponeurotic layer as a parameter. METHODS: Twenty-four male cadavers were used to characterize the model. The tensile force applied to the anterior layers of the rectus abdominis muscle was measured after the linea alba was resected to create an abdominal wall defect. A dynamometer was used to measure the tensile force necessary to cause a 10-mm displacement of the tissues towards the midline. An index that allows comparison of tensile forces from different points was calculated by dividing the tensile force by the distance between the point of force application at the aponeurosis and the midline. RESULTS: Cadaver is a good model for the study of midline incisional hernia. CONCLUSION: Cadaver can be used effectively as a model to evaluate tension of the abdominal wall when tissue advancement and musculoaponeurotic flaps are performed in the repair of midline incisional hernia.

scholarly journals Application of Botulinum Neurotoxin Injections in TRAM Flap for Breast Reconstruction: Intramuscular Neural Arborization of the Rectus Abdominis Muscle

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 269
Author(s):  
Kyu-Ho Yi ◽  
Hyung-Jin Lee ◽  
Ji-Hyun Lee ◽  
Kyle K. Seo ◽  
Hee-Jin Kim
Keyword(s):  
Breast Reconstruction ◽  
Botulinum Neurotoxin ◽  
Rectus Abdominis ◽  
Tram Flap ◽  
Rectus Abdominis Muscle ◽  
Cross Sectional ◽  
Transverse Rectus Abdominis Myocutaneous ◽  
Intramuscular Nerves ◽  
The Ideal

Breast reconstruction after mastectomy is commonly performed using transverse rectus abdominis myocutaneous (TRAM) flap. Previous studies have demonstrated that botulinum neurotoxin injections in TRAM flap surgeries lower the risk of necrosis and allow further expansion of arterial cross-sectional diameters. The study was designed to determine the ideal injection points for botulinum neurotoxin injection by exploring the arborization patterns of the intramuscular nerves of the rectus abdominis muscle. A modified Sihler’s method was performed on 16 rectus abdominis muscle specimens. Arborization of the intramuscular nerves was determined based on the most prominent point of the xyphoid process to the pubic crest. All 16 rectus abdominis muscle specimens were divided into four muscle bellies by the tendinous portion. The arborized portions of the muscles were located on the 5–15%, 25–35%, 45–55%, and 70–80% sections of the 1st, 2nd, 3rd, and 4th muscle bellies, respectively. The tendinous portion was located at the 15–20%, 35–40%, 55–60%, and 90–100% sections. These results suggest that botulinum neurotoxin injections into the rectus abdominis muscles should be performed in specific sections.

Sliding free transverse rectus abdominis myocutaneous flap for closure of a massive abdominal wall defect: A case report

Microsurgery ◽  
2018 ◽  
Vol 39 (2) ◽  
pp. 174-177 ◽  
Author(s):  
Annika Senghaas ◽  
Thomas Kremer ◽  
Volker J. Schmidt ◽  
Leila Harhaus ◽  
Christoph Hirche ◽  
...  
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Myocutaneous Flap ◽  
Abdominal Wall Defect ◽  
Rectus Abdominis ◽  
Transverse Rectus Abdominis Myocutaneous ◽  
Wall Defect ◽  
Rectus Abdominis Myocutaneous Flap

DIAGNOSTIC CRITERIA FOR VISCEROABDOMINAL DISPROPORTION SYNDROME IN GASTROSCHISIS

2021 ◽  
Vol 100 (6) ◽  
pp. 53-59
Author(s):  
D.A. Plokhikh ◽  
◽  
D.E. Beglov ◽  
K.A. Kovalkov ◽  
◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Analytical Study ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Intestinal Wall ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Wall Defect ◽  
Intestinal Tube ◽  
Significant Factors

The objectives of this study were to determine the frequency and search for additional criteria for the diagnosis of visceroabdominal disproportion syndrome (VADS) in newborns with gastroschisis. Materials and methods of research: prospective controlled observational cross-sectional analytical study was carried out in 61 newborns with gastroschisis, admitted from June 2009 to July 2021. To search for the most significant factors indicating the presence of VADS, the following parameters were recorded in the studied patients: the size of the defect in the anterior abdominal wall, the composition of eventrated organs, the presence of a conglomerate of intestinal loops, the diameter of the intestinal tube, the thickness of the intestinal wall, the degree of visceroabdominal disproportion (VAD). Results: VAD was detected in 50 (82%) newborns with gastroschisis. In 10 (17%) cases, VAD was mild, in 27 (44%) – moderate, and in 13 (21%) patients – severe. A moderate direct relationship was found between the size of the anterior abdominal wall defect (r=0.29, p=0.022), intestinal tube diameter (r=0.56; p=0.001) and the severity of VAD. There was a strong direct correlation between the thickness of the intestinal wall, and the frequency and severity of VAD (r=0.93, p=0.001). A direct association was found between the presence of a conglomerate of intestinal loops in the eventrated organs and the frequency of VAD (p=0.002). There was no statistically significant relationship between the number of eventrated anatomical structures with the frequency and degree of VAD (p=0.36). Conclusion: to determine VADS, it is advisable to diagnose the following pathological conditions in patients with gastroschisis: thickening of the intestinal wall, dilatation of the intestinal tube, the presence of a conglomerate of tightly welded eventrated organs, the severity of which is directly proportional to the degree of disproportion.

scholarly journals Management of Anterior Abdominal Wall Defect Using a Pedicled Tensor Fascia Lata Flap: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
K. D. Ojuka ◽  
F. Nangole ◽  
M. Ngugi
Keyword(s):  
Abdominal Wall ◽  
Road Traffic ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Fascia Lata ◽  
Tensor Fascia Lata ◽  
Wall Defect ◽  
Degloving Injury ◽  
Tensor Fascia Lata Flap ◽  
Degloving Injuries

Degloving injuries to anterior abdominal wall are rare due to the mechanism of injury. Pedicled tensor fascia lata is known to be a versatile flap with ability to reach the lower anterior abdomen. A 34-year-old man who was involved in a road traffic accident presented with degloving injury and defect at the left inguinal region, sigmoid colon injury, and scrotal bruises. At investigation, he was found to have pelvic fracture. The management consisted of colostomy and tensor fascia lata to cover the defect at reversal. Though he developed burst abdomen on fifth postoperative day, the flap healed with no complications.

scholarly journals HYDRANENCEPHALY WITH ANTERIOR ABDOMINAL WALL DEFECT- A CASE REPORT

2019 ◽  
Vol 6 (38) ◽  
pp. 2603-2605
Author(s):  
Ritu Saloi ◽  
Roonmoni Deka ◽  
Santanu Kumar Sarma
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Wall Defect

scholarly journals Assessment of the abdominal wall function after pedicled TRAM flap surgery for breast reconstruction: Use of modified mesh repair for the donor defect

2010 ◽  
Vol 43 (02) ◽  
pp. 166-172
Author(s):  
Chacko Cyriac ◽  
Ramesh Kumar Sharma ◽  
Gurpreet Singh
Keyword(s):  
Breast Reconstruction ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Donor Site ◽  
Rectus Sheath ◽  
Donor Site Morbidity ◽  
Tram Flap ◽  
Wall Function ◽  
Abdominal Wall Function

ABSTRACT Background: The pedicled TRAM flap has been a workhorse of autologous breast reconstruction for decades. However, there has been a rising concern about the abdominal wall donor site morbidity with the use of conventional TRAM flap. This has generally been cited as one of the main reasons for resorting to “abdominal wall friendly” techniques. This study has been undertaken to assess the abdominal wall function in patients with pedicled TRAM flap breast reconstruction. The entire width of the muscle and the overlying wide disk of anterior rectus sheath were harvested with the TRAM flap in all our patients and the anterior rectus sheath defect was repaired by a Proline mesh. Materials and Methods: Abdominal wall function was studied in 21 patients who underwent simultaneous primary unipedicled TRAM flap reconstruction after mastectomy for cancer. In all the patients, the abdominal wall defect was repaired using wide sheet of Proline mesh both as inlay and onlay. The assessment tools included straight and rotational curl ups and a subjective questionnaire. The abdominal wall was also examined for any asymmetry, bulge, or hernia. The minimal follow-up was 6 months postoperative. The objective results were compared with normal unoperated volunteers. Results and Conclusions: The harvesting the TRAM flap certainly results in changes to the anterior abdominal wall that can express themselves to a variable degree. A relatively high incidence of asymptomatic asymmetry of the abdomen was seen. There was total absence of hernia in our series even after a mean follow-up period of 15.5 months. A few patients were only able to partially initiate the sit up movement and suffered an important loss of strength. In most patients, synergists took over the functional movement but as the load increased, flexion and rotation performances decreased. The lack of correlation between exercise tests and the results of the questionnaire suggests that this statistically significant impairment was functionally not important. The patients encountered little or no difficulty in theis day-to-day activities. Our modification of use of a wide mesh as inlay and onlay repair minimizes the donor site morbidity. This also avoids maneuvers meant for primary closure of the rectus sheath defects, which can result in distortion of umbilicus. Therefore, in conclusion, the unipedicled TRAM flap should be regarded as a valuable option in breast reconstruction provided careful repair of the abdominal wall defect is undertaken using Proline mesh.

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