Investigation of a connection between abdominal wall defects and severity of the herniation in fetuses with gastroschisis and omphalocele

AbstractAnalyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated internal organs. We studied 22 fetuses (11 with AWDs and 11 without anomalies). In all fetuses we evaluated the xiphopubic distance (XPD) and iliac crest distance (ICD). In fetuses with AWDs we dissected the abdominal wall and measured the width and length of the defect for calculating its area and studying the correlation between the size of the defect with the organs that were herniated. For statistical analysis, the Anova and Tukey post-test were used (p < 0.05). The XPD in the control group had mean of 4.2 mm (2.3–5.9; SD ± 1.11), while in the AWDs it was 4.2 mm (2.9–5.5; SD ± 0.98) (p = 0.4366). The ICD had mean values of 2.5 mm (1.6–3.4; SD ± 0.58) in the control group, and 2.3 mm (1.2–3.0; SD ± 0.56) in AWDs fetuses (p = 0.6963). The number of herniate organs do not have significant correlation with the area of the defect (r2 = 0.2504, p = 0.5068). There is no correlation between the size (area) of abdominal wall defects and the number of the internal organs that herniated. Therefore, the hole size is not a predictor of the severity of the gastroschisis or omphalocele.

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Use of alloplastic meshes in abdominal wounds of rats with induced peritonitis

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000100007 ◽

2014 ◽

Vol 27 (1) ◽

pp. 26-29 ◽

Cited By ~ 3

Author(s):

Rafael Calvão BARBUTO ◽

Ivana DUVAL-ARAUJO ◽

Sumara Marques BARRAL ◽

Raphael Grossi ROCHA ◽

Cristiane de Souza BECHARA ◽

...

Keyword(s):

Tensile Strength ◽

Abdominal Wall ◽

Granulation Tissue ◽

Abdominal Wall Defect ◽

Test Group ◽

Microscopic Analysis ◽

Female Rats ◽

Control Group ◽

Abdominal Wall Defects ◽

Wall Defect

Background : The use of alloplastic meshes has been historically contra-indicated in patients with infection. Aim : To evaluate the use of polypropylene meshes in the treatment of abdominal wall defects in rats with peritonitis. Methods : Twenty Wistar female rats were divided into two groups: induction of peritonitis (test group) and without peritonitis (control group). An abdominal wall defect was created in all animals, and polypropylene mesh was applied. The evaluation of the tensile strength of the mesh was carried out using tensiometer and microscopic analysis of the healing area was done. Results : More adhesion of the mesh to the rat abdominal wall was observed in test group. The histopathological analyses showed prevalence of moderate to accentuated granulation tissue in both groups, without significant differences. Conclusion : The use of the mesh coverage on abdominal wall defects of rats with induced peritonitis did not show worse results than its use in healthy animals, nor was its integration to the resident tissue any worse.

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Left-Sided Gastroschisis

The American Surgeon ◽

10.1177/000313480607200713 ◽

2006 ◽

Vol 72 (7) ◽

pp. 637-640 ◽

Cited By ~ 2

Author(s):

Kenneth W. Gow ◽

Amina Bhatia ◽

Daniel F. Saad ◽

Mark L. Wulkan ◽

Kurt F. Heiss

Keyword(s):

Abdominal Wall ◽

Clinical Course ◽

Abdominal Wall Defect ◽

Abdominal Wall Defects ◽

Wall Defect ◽

The Right

Gastroschisis is a periumbilical, abdominal wall defect arising to the right of the umbilicus. We describe the clinical course of a left-sided gastroschisis in a term female born at 39 weeks’ gestation. To our knowledge, there have been only 14 left-sided abdominal wall defects reported in the literature. We discuss our case and review the literature to try to determine if there is any clinic difference between right- versus left-sided lesions to make recommendations as to management.

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Gastroschisis Is Associated With Placental Delayed Villous Maturation

Pediatric and Developmental Pathology ◽

10.1177/1093526619875877 ◽

2019 ◽

Vol 23 (3) ◽

pp. 197-203

Author(s):

Brittany Ruschkowski ◽

Anthea Lafreniere ◽

Dina El Demellawy ◽

David Grynspan

Keyword(s):

Risk Factors ◽

Abdominal Wall ◽

Maternal Age ◽

Congenital Abnormality ◽

Abdominal Wall Defect ◽

Control Group ◽

Control Groups ◽

Wall Defect ◽

Previous Diagnosis ◽

Kappa Agreement

Gastroschisis is a congenital abnormality characterized by visceral herniation through an abdominal wall defect. While the cause of gastroschisis is unknown, it has been linked to risk factors including young maternal age, smoking, and alcohol use during pregnancy. To date, the only established placental correlate is amniocyte vacuolization. Based on our clinical experience, we hypothesized that delayed villous maturation (DVM) is also associated with gastroschisis. We conducted a retrospective slide review of 23 placentas of neonates with gastroschisis. Additionally, we selected 2 control groups of placentas: 1 with a previous diagnosis of DVM and 1 with normal villous morphology. All placentas were randomized and reviewed by 2 perinatal pathologists, who were blinded to the group; DVM and amniocyte vacuolization were assessed. Gastroschisis was associated with increased placental DVM in 65.2% of cases (vs 13.6% of controls; P = .0007) and increased amniocyte vacuolization in 52.2% of cases (vs 9.1% of controls; P = .003) compared to the control group. Based on the normal and DVM groups, kappa agreement between current slide review and initial pathology diagnosis was 0.419, indicating moderate agreement. Our study shows that gastroschisis is associated with placental DVM. This association may be due to (1) a common upstream factor contributing to both gastroschisis and DVM or (2) DVM may be a consequence of the altered placental and amniotic environment in the context of gastroschisis.

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The Oscar Ramirez Procedure, a Solution for Treating Incisional Hernias with Big Abdominal Wall Defect

Acta Medica Marisiensis ◽

10.2478/amma-2014-0026 ◽

2014 ◽

Vol 60 (3) ◽

pp. 122-124

Author(s):

M. Gherghinescu ◽

D. Popa ◽

A. Panțiru ◽

C. Russu ◽

C. Roșca ◽

...

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Defect ◽

Postoperative Recovery ◽

Oblique Muscle ◽

Abdominal Wall Defects ◽

Hernia Sac ◽

Wall Defect ◽

External Edge ◽

Incisional Hernias ◽

Bowel Movements

Abstract Background: Incisional hernias are important complications of abdominal surgery. Normally they are followed by the growth of the hernia sac and an increase of the abdominal wall defect with loss of domain of the herniated organs. Case report: We report a case of a 51 year old female, admitted in the 1st Surgical Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș with a large median reducible incisional hernia and a wall defect of 10/12 cm. The abdominoplasty was performed using the Oscar Ramirez technique, which consists of a longitudinal incision along the aponeurosis of the external oblique muscle, at approximately 1-2 cm from the external edge of the rectus abdominis. This procedure allows the abdominal wall closure. This case is part of a lot of 4 patients who received this treatment using the aforementioned procedure in the past 2 months. Postoperative recovery was favorable, bowel movements were present on the second day after the surgery, the subcutaneous drains were shortened on the fifth day and removed on the sixth. There were no immediate postoperative complications or up to a month after the surgery. The patient was discharged on the seventh day. Conclusions: This technique can be used alone in case of large abdominal wall defects, or prequeling an on-lay mesh procedure addressed to a weak abdominal wall, case in which the functional result is superior to a substitutional mesh.

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

Case Reports in Surgery ◽

10.1155/2014/723851 ◽

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.

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One of Curious Congenital Midline Abdominal Defects In Newborn: A Giant Omphalozele In A 3 Years-Old Boy

Journal of Regenerative Biology and Medicine ◽

10.37191/mapsci-2582-385x-3(4)-073 ◽

2021 ◽

Author(s):

Stefan Bittmann

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Defect ◽

Abdominal Wall Defects ◽

Wall Defect ◽

Lateral Abdominal Wall ◽

The Third ◽

Abdominal Organs ◽

Wall Components ◽

Congenital Abdominal Wall Defects

Omphalocele is one of the congenital abdominal wall defects and specifically refers to an umbilical ring defect in which the abdominal organs protrude in front of the abdominal wall in a thin sac or membrane. Such an abdominal wall defect develops around the third week of pregnancy due to the failure of adhesion between the embryonic lateral abdominal wall components.

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Abdominal wall repair with human acellular dermal autograft

Surgical Techniques Development ◽

10.4081/std.2012.e6 ◽

2011 ◽

Vol 2 (1) ◽

pp. 6

Author(s):

Roel E. Genders ◽

Paul P.G.M. Kouwenberg ◽

Rob P. Bleichrodt

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Defect ◽

Operative Procedure ◽

Abdominal Wall Defects ◽

Dermal Matrix ◽

Wall Defect ◽

Mortality And Morbidity ◽

Acellular Dermis ◽

Number Of Patients ◽

Acellular Dermal

Repair of abdominal wall defects in the presence of contamination or infection is a significant problem. The loss of tissue warrants enforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive surgery. This paper presents a review of available literature of placement of an acellular human dermis to repair an abdominal fascia defect, in contaminated as well as in non-contaminated surgical fields. It is illustrated with a case report that describes the successful reconstruction of an infected abdominal wall defect with a human acellular dermis allograft. A systematic literature review was undertaken with searches performed in the Pubmed and Cochrane databases for the period up till March 2009, using the search terms Alloderm [Substance Name], Hernia [Mesh] and the key words acellular dermis, acellular dermal matrix, human acellular dermal allograft and abdominal wall defect. To assess methodological quality, each article was subjected to a modification of the methodological index for non-randomized studies (MINORS) according to Slim et al. Two items from the original index were not included because none of the studies selected had an unbiased assessment of the study end points and in none of the studies was a prospective calculation of the study size performed. Seventeen studies were included in the review. Data were extracted regarding study design, number of patients, surgical technique, followup period, contaminated or non-contaminated area of the fascia defect, mortality and morbidity (hemorrhage, seroma, wound dehiscence, infection) of the operative procedure, the longterm results (removal of the graft, reherniation and bulging) and level of evidencey. A total of 169 short-term complications and 151 longterm complications occurred after 643 surgical procedures reconstructing both contaminated and clean abdominal wall defects by implantation of an HADA. Human acellular dermal allograft seems to be a good alternative for autologous repair of contaminated or infected abdominal wall defects.

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Comparative Cellular Local Response in Abdominal Defect Plastic Surgery with Bovine Pericardium and Bovine Fascia Preserved in Formaldehyde in Experimental Rabbits

ARS Medica Tomitana ◽

10.1515/arsm-2017-0016 ◽

2017 ◽

Vol 23 (2) ◽

pp. 83-93

Author(s):

Eva Gudemac ◽

S. Babuci ◽

C. Tica ◽

V. Petrovici ◽

V. Nacu ◽

...

Keyword(s):

Abdominal Wall ◽

Direct Contact ◽

Anterior Abdominal Wall ◽

Abdominal Wall Defect ◽

Bovine Pericardium ◽

Congenital Defects ◽

Abdominal Wall Defects ◽

Wall Defect ◽

Fascia Graft ◽

Subcutaneous Layer

AbstractIn the present paper, we refer to a method of primary closure of congenital defects of the anterior abdominal wall with tensionless viscero-abdominal disproportion. The study group included 10 animals subjected to surgery of the abdominal wall defect closure with bovine pericardium graft preserved in 0.5% formaldehyde, and 5 rabbits of the same breed and weight, in which bovine fascia graft was used as implant, being preserved in 0.5% formaldehyde. The abdominal anterior wall defect was made surgically by excision of the musculo-fascial structures and peritoneum. Bovine pericardium graft and bovine fascia graft were placed and fixed posteriorly to rectus abdominals muscles, having direct contact with the intra-abdominal contents and protected by suturing skin and subcutaneous layer.The purpose of the study was to perform a comparative postoperative evaluation of local macroscopic and microscopic changes that develop after reconstruction of the major abdominal wall defects experimentally induced in rabbits, using bovine pericardium and bovine fascia grafts preserved in 0.5% formaldehyde.In cases of major fascial defects of the anterior abdominal wall, bovine pericardium graft has acceptable strength and biocompatibility, having stabilizing properties of the abdominal wall due to the development of the connective tissue layer located between the implant and the subcutaneous layer. Bovine fascia grafts preserved in formaldehyde have an insignificant irritating and inflammatory action on the intestinal loops compared with bovine pericardium, and do not induce the development of a significant abdominal adhesion process, this allowing their use in the abdominal fascial defects closure with placement in direct contact with the abdominal contents.

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Nonwoven polypropylene prosthesis in large abdominal wall defects in rats

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502012001000002 ◽

2012 ◽

Vol 27 (10) ◽

pp. 671-680 ◽

Cited By ~ 1

Author(s):

Patrick dos Santos Barros dos Reis ◽

Vera Lucia Antunes Chagas ◽

Jéssica Marquet Silva ◽

Paulo Cesar Silva ◽

Nelson Jamel ◽

...

Keyword(s):

Abdominal Wall ◽

Polypropylene Mesh ◽

Abdominal Wall Defect ◽

Therapeutic Option ◽

Abdominal Wall Defects ◽

Scanning Calorimetry ◽

Wall Defect ◽

Simulation Group ◽

Hematoxylin Eosin ◽

Group 1

PURPOSE: To evaluate, in large abdominal wall defects surgically shaped in rats, if a synthetic polypropylene nonwoven prosthesis could be used as a therapeutic option to conventional polypropylene mesh. METHODS: Twenty four (24) Wistar rats were enrolled into three groups. Group 1 (Simulation group) with an abdominal wall defect of 3 X 3 left untreated and Groups 2 and 3, respectively treated with a conventional polypropylene mesh and a polypropylene nonwoven (NWV) prosthesis to cover the breach. At the 45th postoperatively day, adhesion (area and strength) and vascularization of Groups 2 and 3 were evaluated. The histological preparations with Hematoxylin-Eosin, Tricromium of Masson, Pricrosirius red and polarization with birefringence, and also the structural analysis of the prostheses carried on by Thermogravimetry and Differential Scanning Calorimetry were also assessed. RESULTS: There were no significant differences between the Groups 2 and 3. CONCLUSION: In rats, the polypropylene nonwoven prosthesis showed to be safe and has to be considered as an alternative to conventional mesh manufactured by weaving in the treatment of great defects of the abdominal wall.

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Engineering of Skeletal Muscle Tissue Using Myoblast-Seeded Bovine Pericardium for Reconstruction of Abdominal Wall Defect in a Rabbit Model

Journal of Biomimetics Biomaterials and Tissue Engineering ◽

10.4028/www.scientific.net/jbbte.8.9 ◽

2010 ◽

Vol 8 ◽

pp. 9-21

Author(s):

T. Ayele ◽

A.B.Z. Zuki ◽

M.M. Noordin ◽

B.M.A. Noorjahan

Keyword(s):

Skeletal Muscle ◽

Treatment Group ◽

Abdominal Wall ◽

Muscle Tissue ◽

Abdominal Wall Defect ◽

Rabbit Model ◽

Bovine Pericardium ◽

Skeletal Muscle Tissue ◽

Control Group ◽

Abdominal Wall Defects

A novel tissue engineered construct was used to engineer skeletal muscle tissue for reconstruction of abdominal wall defects, which is a common challenge to surgeons, due to insufficient autogenous tissue. Myoblasts were isolated from soleus muscle fibers, seeded onto the scaffold and cultivated in vitro for 5 days. Full-thickness abdominal wall defects (3 x 4 cm) were created in 18 male New Zealand white rabbits and randomly divided into two equal groups (n=9 each). The defects of the first group were repaired with myoblast seeded bovine pericardium (treatment group) whereas the second group involved non-seeded bovine pericardium (control group). Three animals were sacrificed at 7, 14, and 30 days post-implantation from each group and the explanted specimens were subjected to macroscopic, light, fluorescence and electron microscopic analysis. In each case, the tissue engineered construct was thicker from deposition of newly formed collagen with neo-vascularisation, than the control group. Most importantly, multinucleated myotubes and myofibers were only detected in the treatment group. Therefore, this study demonstrates that myoblast-seeded bovine pericardium construct can provide a structural replacement for severe and large abdominal wall defects with profound regeneration of skeletal muscle tissues.

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