A simple method for locating the linea alba in midline laparotomy incisions

The aim of the study was to present clinical observations regarding the reposition of uterine torsion in pregnant mares. Treatments were performed in 10 mares hospitalized with a diagnosis of uterine torsion in the period from the 8th to the 11th month of pregnancy, including one mare treated during delivery. In 4 mares, obstetric examination revealed the presence of dead fetuses. In one mare admitted during labor, Kamer's repositioning technique was applied by inserting a hand through the vagina into the uterus. In all other cases, mares underwent surgical repositioning after laparotomy performed in linea alba. In 4 mares, in which the uterine wall was at risk of rupture during handling because of advanced changes, a caesarean section was performed before repositioning. Eight out of the 9 mares survived treatment and recovered without complications. One of five mares in which live fetuses were left, miscarried, while the other four delivered healthy foals. Uterine torsion reposition by midline laparotomy offers the best possibilities for inspecting the abdominal cavity, including the uterus, and for detecting any other abnormalities of the digestive system. In the case of mares in which fetuses were left, spontaneous delivery had no adverse effect on the healing of the wound.

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Prospective comparative study of modified Smead Jones versus conventional continuous method of fascial closure in emergency midline laparotomy

International Surgery Journal ◽

10.18203/2349-2902.isj20204678 ◽

2020 ◽

Vol 7 (11) ◽

pp. 3713

Author(s):

Chirag B. Aghara ◽

Ajay M. Rajyaguru ◽

Jatin G. Bhatt

Keyword(s):

Wound Infection ◽

Fascial Closure ◽

Emergency Laparotomy ◽

Closure Technique ◽

Midline Laparotomy ◽

Linea Alba ◽

Hernia Prevention ◽

Group A ◽

Group B ◽

Continuous Closure

Background: A midline incision is simple, quick, bloodless and provides excellent exposure. So it is most commonly used access route for emergency laparotomy. But compare to other incision it increases incidence of postoperative wound dehiscence and an incisional hernia. Prevention of this complication is important in reducing post-operative morbidity and mortality. Present study was undertaken to compare the effectiveness of modified Smead Jones versus conventional continuous closure technique in terms of wound infection and wound dehiscence.Methods: A total of 100 patients from July 2017 to November 2019 were randomized in two groups of 50 each. Group A in which linea alba closure was done by modified Smead Jones technique and group B in which linea alba closure was done by conventional continuous closure technique.Results: 12 patients in group A and 28 patients in group B developed wound infection and 1 patient in group A and 7 patients in group B developed wound dehiscence.Conclusions: Modified Smead Jones technique is better than conventional continuous closure technique in management of closure of emergency midline laparotomy.

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P106 PROPHYLACTIC MESH FOR PREVENTION OF INCISIONAL HERNIA IN HIGH-RISK PATIENTS: PVDF “VISIBLE” MESH BEHAVIOUR ON MRI

British Journal of Surgery ◽

10.1093/bjs/znab395.099 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Beatriz Carrasco Aguilera ◽

Marina da Silva Torres ◽

Jose Rodicio ◽

Ana Fernández del Valle ◽

Maria Moreno ◽

...

Keyword(s):

High Risk ◽

Incisional Hernia ◽

Gastrointestinal Surgery ◽

Safe Procedure ◽

Prophylactic Mesh ◽

Midline Laparotomy ◽

Linea Alba ◽

High Risk Patients ◽

Risk Patients

Abstract Aim According to the guidelines, prophylactic mesh placement appears to be an effective, safe procedure in high-risk patients for the prevention of incisional hernia (IH) after midline laparotomy, without its use being standardized. Knowing its radiological behaviour can resolve doubts about its use. Material and Methods This was a prospective observational cohort study. The included patients needed to have more than one risk factor for IH (age> 60 years old, Body Mass Index > 30kg/m2, diabetes, chronic bronchopathy, heart disease, smoking, kidney disease, neoplasia, liver disease, immunosuppression or an emergency operation). Follow-up included 6-week and 12-month postoperative magnetic resonance imaging (MRI). If MRI was not performed, we used the follow-up computed tomography (CT). Results Between July 2016 and March 2021, 54 patients were enrolled in the study. Surgery was emergent in 14.8% of cases, clean-contaminated in 87% and upper gastrointestinal surgery in 51.9%. A total of 43 MRI and 3 CT at 6-week and 30 MRI and 2 CT at 12-month were carried out. The median of the mesh area were 150.7 vs 150,1cm2 respectively. 91% of cases had the mesh lined to the fascia at 12 months. The bridging in the linea alba was zero in 61% at 6-weeks and 24% at 12-month follow-up, mean 9 vs 19mm (p = 0.001). Conclusions The use of imaging tests to know the postoperative behaviour of a Polyvinylidenfluorid (PVDF) “visible” mesh shows us that there is no mesh contraction at one year or detachment of the fascia, however we observe a significant tendency in the separation of the linea alba.

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Linea alba dehiscence following ventral midline laparotomy in horses

Equine Veterinary Journal ◽

10.1111/evj.03_13492 ◽

2021 ◽

Vol 53 (S55) ◽

pp. 7-7

Keyword(s):

Ventral Midline ◽

Midline Laparotomy ◽

Linea Alba

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A comparative study of single layer closure versus conventional layered closure of laparotomy wounds

International Surgery Journal ◽

10.18203/2349-2902.isj20181130 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1459

Author(s):

Akash Bande ◽

Divish Saxena ◽

Prabhat B. Nichkaode ◽

Murtaza Akhtar

Keyword(s):

Abdominal Wall ◽

Tertiary Care ◽

Single Layer ◽

Closure Technique ◽

Midline Laparotomy ◽

Linea Alba ◽

Mass Closure ◽

Interrupted Suture ◽

Closure Group ◽

Better Than

Background: The goal of wound closure after laparotomy is to restore the function of the abdominal wall. The techniques for closure of anterior abdominal wall includes either layered closure, modified Smead-Jones technique, mass closure or retention suture or combination of above mentioned techniques. The studies which compared the continuous and interrupted suture techniques have concluded that enmass continuous sutures have an advantage of holding the fascia together. The present study tries to compare the two techniques i.e. single layer closure (mass closure) and layered closure in patients undergoing laparotomy by midline incision in tertiary care hospital.Methods: 97 patients undergoing either emergency or elective midline laparotomy were included in the study, where in 64 patients laparotomy closure was done in single layer using polypropylene 1-0 and in 33 patients by layered closure where peritoneum was closed with polygalactin 2-0 and linea alba by polypropylene 1-0. Patients were allocated two groups as per convenience of operating surgeon without using any method of randomization.Results: The single layer closure technique required statistically significant less closure time of 18.2±3.2 minutes as compared to conventional layered closure 26.4±4 minutes time of (p <0.001). Also, the incidence of postoperative complications was found to be comparatively less (17.18%) in single layer closure group as compared to complications (42.42%) in layered closure group.Conclusions: Single layer closure technique continues to be better than conventional layered closure technique of laparotomy wounds in terms of operative time and post-operative complications.

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A simple way for producing holographic filters suitable for image improvement

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100108271 ◽

1978 ◽

Vol 36 (1) ◽

pp. 226-227

Author(s):

K.-H. Herrmann ◽

E. Reuber ◽

P. Schiske

Keyword(s):

Transfer Functions ◽

Diffraction Order ◽

Lateral Position ◽

Simple Method ◽

Spatial Frequencies ◽

Resolution Electron ◽

Wiener Filters ◽

Image Improvement ◽

Optical Reconstruction ◽

Set Up

Aposteriori deblurring of high resolution electron micrographs of weak phase objects can be performed by holographic filters [1,2] which are arranged in the Fourier domain of a light-optical reconstruction set-up. According to the diffraction efficiency and the lateral position of the grating structure, the filters permit adjustment of the amplitudes and phases of the spatial frequencies in the image which is obtained in the first diffraction order.In the case of bright field imaging with axial illumination, the Contrast Transfer Functions (CTF) are oscillating, but real. For different imageforming conditions and several signal-to-noise ratios an extensive set of Wiener-filters should be available. A simple method of producing such filters by only photographic and mechanical means will be described here.A transparent master grating with 6.25 lines/mm and 160 mm diameter was produced by a high precision computer plotter. It is photographed through a rotating mask, plotted by a standard plotter.

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Rotary Beveling for In Situ Thin-Section Microscopy of Cell Cultures

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100099192 ◽

1981 ◽

Vol 39 ◽

pp. 550-551

Author(s):

Dean A. Handley ◽

Jack T. Alexander ◽

Shu Chien

Keyword(s):

Cell Growth ◽

Cell Cultures ◽

Molecular Interactions ◽

Convenient Method ◽

Petri Dish ◽

Simple Method ◽

Thin Section Microscopy ◽

Thin Sectioning ◽

Organic Fluids

In situ preparation of cell cultures for ultrastructural investigations is a convenient method by which fixation, dehydration and embedment are carried out in the culture petri dish. The in situ method offers the advantage of preserving the native orientation of cell-cell interactions, junctional regions and overlapping configurations. In order to section after embedment, the petri dish is usually separated from the polymerized resin by either differential cryo-contraction or solvation in organic fluids. The remaining resin block must be re-embedded before sectioning. Although removal of the petri dish may not disrupt the native cellular geometry, it does sacrifice what is now recognized as an important characteristic of cell growth: cell-substratum molecular interactions. To preserve the topographic cell-substratum relationship, we developed a simple method of tapered rotary beveling to reduce the petri dish thickness to a dimension suitable for direct thin sectioning.

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