scholarly journals Flap Surgical Techniques For Incisional Hernias Reccurences. A Swine Experimental Model

2017 ◽  
Vol 90 (2) ◽  
pp. 203-211
Author(s):  
Florina Popa ◽  
Filip Ardelean ◽  
Cosmin Pestean ◽  
Robert Purdoiu ◽  
Oana Rosca ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Mesh Repair ◽  
Surgical Techniques ◽  
Careful Examination ◽  
Large Animal ◽  
Abdominal Wall Defects ◽  
Flap Surgery ◽  
Abdominal Wall Repair ◽  
Large Animal Models ◽  
The University

Background and aims. In the age of synthetic prostheses most of hernia studies include a careful examination of the various types of prosthesis, their characteristics and their repair indications. Biological prostheses are also beginning to draw attention. But in terms of recurrence especially for poor or developing countries, the discussion is different, due to their high cost which makes them difficult to afford. In this article we present new flap reconstruction techniques for the reconstruction of the abdominal wall versus mesh repair, applied on swine models, outline the results of each technique, and specify the indications for their use.Methods. An experimental protocol using four swine models (PIC-FII-337 hybrid breed pigs), five months old, was conducted. All animal care and operative procedures were studied following the protocol approved by the Ethics Committee of the University of Medicine and Pharmacy resolution no. 281/2014 of the Department of Surgery of the University of Agricultural Sciences and Veterinary Medicine); the study was carried out between November 2015 and February 2016. The primary objective was to compare the effect of surgical strategies in the treatment of the abdominal wall defect using variable flaps versus mesh repair in a large-animal models. Physical examination and ultrasound imaging of the abdominal wall repair were done on determined periods, during one month. The complications occurring after the abdominal wall repair were edema, collections, superficial dehiscence an recurrences.Results. No recurrences were reported at one month results, all seromas reported were solved over time by natural drainage. Superficial necrosis appeared in two swine models and superficial dehiscence occurred in one model, the perforator ”plus” flap. Mesh infection was detected in the “onlay” swine model.Conclusions. In terms of recurrences, contaminated abdominal wall defects or other contraindications to the use of prosthetic materials, biological mesh repair or flap surgery are the only surgical options. Based on our findings and considering the high cost reported by the biological meshes use, flap surgery becomes the suitable treatment for such cases, allowing a good reconstruction of the abdominal wall.

Niche Reconstructive Techniques for Complex Abdominal Wall Reconstruction: A Review

2014 ◽  
Vol 80 (4) ◽  
pp. 327-334 ◽  
Author(s):  
Gloria R. Sue ◽  
Deepak Narayan
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Surgical Techniques ◽  
Abdominal Wall Defects ◽  
Recurrence Rates ◽  
Surgical Morbidity ◽  
Abdominal Wall Repair ◽  
Surgical Methods ◽  
Latissimus Dorsi Myocutaneous Flap ◽  
Reconstructive Techniques

Abdominal wall defects resulting from recurrent hernias, trauma, and radiation necrosis are difficult and challenging to repair given the high rates of recurrence and surgical morbidity. Complex abdominal wall defects often require the transposition of autologous material to bridge the fascial gap. We present a review of niche reconstructive techniques that have been used in complex abdominal wall repair. The specific techniques reviewed include use of delayed and tunneled pedicled tensor fascia lata myofascial flap, de-epithelialized flap closure, free latissimus dorsi myocutaneous flap with or without innervation, and abdominal wall transplant. These niche surgical techniques have great potential to reduce recurrence rates when used in the proper setting for complex abdominal wall reconstruction. More studies are needed to evaluate the relative use of these techniques with the more widely established surgical methods of reconstruction.

scholarly journals In vivo cerebral aneurysm models

2019 ◽  
Vol 47 (1) ◽  
pp. E20 ◽  
Author(s):  
John W. Thompson ◽  
Omar Elwardany ◽  
David J. McCarthy ◽  
Dallas L. Sheinberg ◽  
Carlos M. Alvarez ◽  
...  
Keyword(s):  
Cerebral Aneurysm ◽  
Surgical Techniques ◽  
Cerebral Aneurysms ◽  
Aneurysm Rupture ◽  
Large Animal ◽  
Pharmacological Interventions ◽  
Large Animal Models ◽  
First Line Therapy ◽  
Endovascular Devices

Cerebral aneurysm rupture is a devastating event resulting in subarachnoid hemorrhage and is associated with significant morbidity and death. Up to 50% of individuals do not survive aneurysm rupture, with the majority of survivors suffering some degree of neurological deficit. Therefore, prior to aneurysm rupture, a large number of diagnosed patients are treated either microsurgically via clipping or endovascularly to prevent aneurysm filling. With the advancement of endovascular surgical techniques and devices, endovascular treatment of cerebral aneurysms is becoming the first-line therapy at many hospitals. Despite this fact, a large number of endovascularly treated patients will have aneurysm recanalization and progression and will require retreatment. The lack of approved pharmacological interventions for cerebral aneurysms and the need for retreatment have led to a growing interest in understanding the molecular, cellular, and physiological determinants of cerebral aneurysm pathogenesis, maturation, and rupture. To this end, the use of animal cerebral aneurysm models has contributed significantly to our current understanding of cerebral aneurysm biology and to the development of and training in endovascular devices. This review summarizes the small and large animal models of cerebral aneurysm that are being used to explore the pathophysiology of cerebral aneurysms, as well as the development of novel endovascular devices for aneurysm treatment.

scholarly journals Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages

2020 ◽  
Vol 8 ◽  
pp. 205031212096872
Author(s):  
Yoram Y Fleissig ◽  
Jason E Beare ◽  
Amanda J LeBlanc ◽  
Christina L Kaufman
Keyword(s):  
Upper Extremity ◽  
Hind Limb ◽  
Large Body ◽  
Surgical Techniques ◽  
Experimental Models ◽  
Tissue Loss ◽  
Large Animal ◽  
Solid Organ ◽  
Vascularized Composite Allotransplantation ◽  
Large Animal Models

As clinical experience with surgical techniques and immunosuppression in vascularized composite allotransplantation recipients has accumulated, vascularized composite allotransplantation for hand and face have become standard of care in some countries for select patients who have experienced catastrophic tissue loss. Experience to date suggests that clinical vascularized composite allotransplantation grafts undergo the same processes of allograft rejection as solid organ grafts. Nonetheless, there are some distinct differences, especially with respect to the immunologic influence of the skin and how the graft is affected by environmental and traumatic insults. Understanding the mechanisms around these similarities and differences has the potential to not only improve vascularized composite allotransplantation outcomes but also outcomes for all types of transplants and to contribute to our understanding of how complex systems of immunity and function work together. A distinct disadvantage in the study of upper extremity vascularized composite allotransplantation recipients is the low number of clinical transplants performed each year. As upper extremity transplantation is a quality of life rather than a lifesaving transplant, these numbers are not likely to increase significantly until the risks of systemic immunosuppression can be reduced. As such, experimental models of vascularized composite allotransplantation are essential to test hypotheses regarding unique characteristics of graft rejection and acceptance of vascularized composite allotransplantation allografts. Rat hind limb vascularized composite allotransplantation models have been widely used to address these questions and provide essential proof-of-concept findings which can then be extended to other experimental models, including mice and large animal models, as new concepts are translated to the clinic. Here, we review the large body of rat hind limb vascularized composite allotransplantation models in the literature, with a focus on the various surgical models that have been developed, contrasting the characteristics of the specific model and how they have been applied. We hope that this review will assist other researchers in choosing the most appropriate rat hind limb transplantation model for their scientific interests.

scholarly journals Large defect of abdominal wall repair by dermal and sinthetic graft

2003 ◽  
Vol 50 (2) ◽  
pp. 19-24
Author(s):  
Danilo Stojiljkovic ◽  
Milan Visnjic ◽  
Srbobran Trenkic ◽  
Zoran Rancic ◽  
Dragan Milic ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Difficult Problem ◽  
Abdominal Wall Defects ◽  
Time Intervals ◽  
Large Defect ◽  
Abdominal Wall Repair ◽  
Dermal Graft ◽  
Synthetic Grafts ◽  
Gross Examination

Large defects of abdominal wall (greater than 8 cm in diameter) related to different cause, are still difficult problem of modern surgery. The best results in order to obtain safe and permanent anatomical and functional abdominal wall integrity are reached by autogenous dermal and synthetic grafts. Controversies concerning quality of these procedures are still presents. Our work is based on two equal experimental groups of 20 Vister rats each, with large artificial abdominal wall defects: one treated with autogenous dermal graft, another with synthetic Mersilene mesh graft. The animals from both groups were sacrificed in previous planned time intervals (3rd, 7th, 14th and 48th days). Afterwards detailed microscopic and gross examination of abdominal wall reparation and quality of reconstructed abdominal wall defects had been performed. According to our results both methods are easy to be performed and safety surgical procedures. Overestimated usage of synthetic grafts should be diminished because of advantages of autologous dermal graft - availability, substitution of firmly fibrosis tissue and endurance against infection.

scholarly journals Abdominal wall repair with double-mesh polypropylene/polyglecaprone after TRAM flap surgery for breast reconstruction

2014 ◽  
Vol 29 (4) ◽  
Author(s):  
EVELYNE GABRIELA SCHMALTZ CHAVES MARQUES ◽  
JOÃO LUIS GIL JORGE ◽  
CAMILA ZIRLIS NAIF DE ANDRADE ◽  
MARCELO FELIX DA SILVA ◽  
JAYME ADRIANO FARINA JUNIOR
Keyword(s):  
Breast Reconstruction ◽  
Abdominal Wall ◽  
Tram Flap ◽  
Flap Surgery ◽  
Abdominal Wall Repair

Abdominal Wall Vascularized Composite Allotransplantation: A Scoping Review

2021 ◽  
Author(s):  
Valeria P. Bustos ◽  
Joseph M. Escandón ◽  
Eric Santamaría ◽  
Pedro Ciudad ◽  
Antonio J. Forte ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Scoping Review ◽  
Surgical Techniques ◽  
Research Strategy ◽  
Human Studies ◽  
Abdominal Wall Defects ◽  
Complication Rates ◽  
Vascularized Composite Allotransplantation ◽  
Level Of Evidence ◽  
Scoping Reviews

Abstract Background Abdominal wall vascularized composite allotransplantation (AW-VCA) is a novel reconstructive technique used for large abdominal wall defects in combination with intestinal transplantation (ITx) or multivisceral abdominal transplantation (MVTx). Since the introduction of this procedure, several studies have been published reporting their experience. This study aims to present a scoping review looking at all available evidence-based medicine information to understand the most current surgical techniques and clinical outcomes. Methods This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) extension for scoping reviews checklist. A comprehensive research strategy of several databases was conducted. Results A total of 31 studies were included in this review, which comprised animal, cadaveric, and human studies. In human studies, four surgical techniques with high flap survival rates and low complication rates were found. In cadaveric studies, it was shown that the use of iliofemoral cuff-based flaps provided adequate tissue perfusion to the abdominal wall graft. Also, the use of thoracolumbar nerves have been described to provide functionality to the AW-VCA and prevent long-term muscle atrophy. Conclusion AW-VCA is a safe and efficient alternative for patients with large and complex abdominal wall defects. The future holds a promising evolution of a functional AW-VCA, though surgeons must face and overcome the challenge of distorted anatomy frequently present in this population. Forthcoming studies with a better level of evidence are required to evaluate functionality and differences between surgical techniques.

scholarly journals The results of expanded-polytetrafluoroethylene mesh repair in difficult abdominal wall defects

2019 ◽  
Vol 42 (1) ◽  
pp. 131-143 ◽  
Author(s):  
Tarkan Ünek ◽  
Selman Sökmen ◽  
Tufan Egeli ◽  
Vildan Avkan Oğuz ◽  
Hülya Ellidokuz ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Mesh Repair ◽  
Abdominal Wall Defects ◽  
Expanded Polytetrafluoroethylene

scholarly journals Abdominal Wall Reconstruction after Flap Surgery and the Effect on the Immune System

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
F. Popa ◽  
A. V. Georgescu
Keyword(s):  
Animal Models ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Control Group ◽  
Surgical Trauma ◽  
Abdominal Wall Defects ◽  
Flap Surgery ◽  
Proinflammatory Response ◽  
Flap Repairs ◽  
The Impact

Background. The aim of our study was to investigate the impact of abdominal wall reconstruction surgery on tissue anatomy and to explore how flap surgery influences the patient’s immune status. Methods. Experimental abdominal wall defects were created in 8 Sus scrofa (swine) animal models. The animals were divided into two groups: 4 swine were euthanized one month after surgery for the biopsies retrieval purpose and the other 4 swine were kept alive and the collection of blood samples has been done 6 months after surgery. In order to evaluate the relative gene expression in operated-on animal cohorts we compared them with samples from 4 healthy swine used as controls. Results. The inflammatory process was present in all types of repairs. Collagen I deposition was higher in the flap repairs. The expression level for the genes related to immune response after 6 months from surgery was relatively similar to the control group except minor alteration registered in the case of two swine models. Conclusion. Our findings indicate a less pronounced proinflammatory response to surgical trauma in animal models after flap surgery. The postoperative levels of the inflammatory cytokines did not show significant differences after abdominal wall reconstruction using flap surgery.

Sign in / Sign up

Export Citation Format

Share Document