scholarly journals Intra abdominal pressure changes in meshplasty and abdominal wall plication techniques in abdominoplasty: a comparative study

2021 ◽  
Vol 8 (11) ◽  
pp. 3370
Author(s):  
Ramya Thulaseedharan Pillai ◽  
Varghese Joseph ◽  
Krishnakumar Marar
Keyword(s):  
Comparative Study ◽  
Abdominal Wall ◽  
Symptomatic Treatment ◽  
Study Groups ◽  
Abdominal Pressure ◽  
Rectus Diastasis ◽  
Abdominal Hypertension ◽  
Soft Tissue Laxity ◽  
Patients At Risk ◽  
Pressure Changes

Background: Measurement of intra abdominal pressures is used to identify patients at risk of intra-abdominal hypertension and abdominal compartment syndrome after abdominoplasty that may lead to tight closure of the abdomen. This comparative study was aimed at measuring the IAP of patients in groups of meshplasty and abdominal wall plication, intraoperatively and post operatively.Methods: A comparative study was conducted among 34 patients who underwent meshplasty and abdominal wall plication. Each group comprised of 17 patients. All preoperative blood investigations and pre anesthetic evaluations were done. The technique used is decided based on the soft tissue laxity, rectus diastasis and presence of ventral hernias. Intra operatively, IAP was measured soon after the placement of mesh or after Rectus plication and post operatively, IAP was measured within 24 hours. IAP was measured using the intra vesical technique using Foley’s Catheter.Results: Fifty percent of the total patients were in the age group 41-50yrs and 88.2% of the patients were females. No significant variations in IAP, either intraoperative (p=0.051) or post operative (p=0.202), was evidenced in both groups. Post operatively, patient developed minimal complications such as seroma collection, wound infection and respiratory complications, improving on symptomatic treatment and antibiotics.Conclusions: No significant intraoperative or postoperative IAP was found between the two study groups underwent meshplasty and abdominal wall placation techniques.

Intra-abdominal Hypertension

2010 ◽  
Vol 21 (2) ◽  
pp. 205-217
Author(s):  
John J. Gallagher
Keyword(s):  
Fluid Resuscitation ◽  
Traumatic Injury ◽  
Major Surgery ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Patients At Risk ◽  
Wall Compliance ◽  
Massive Fluid ◽  
Abdominal Wall Compliance ◽  
Improve Patient

Intra-abdominal hypertension occurs in 50% of all patients admitted to the intensive care unit and is associated with significant morbidity and mortality. Intra-abdominal hypertension is defined as a sustained, pathologic rise in intra-abdominal pressure to 12 mm Hg or more. Patients with intra-abdominal hypertension may progress to abdominal compartment syndrome. Early identification and treatment of this condition will improve patient outcome. Patients at risk for intra-abdominal hypertension include those with major traumatic injury, major surgery, sepsis, burns, pancreatitis, ileus, and massive fluid resuscitation. Predisposing factors include decreased abdominal wall compliance, increased intraluminal contents, increased peritoneal cavity contents, and capillary leak/fluid resuscitation.

scholarly journals Effect of intra-abdominal hypertension on the strength of the postoperative scar of a laparotomic wound

2020 ◽  
Vol 24 (2) ◽  
pp. 223-226
Author(s):  
I. K. Morar
Keyword(s):  
Mechanical Strength ◽  
Negative Impact ◽  
Abdominal Cavity ◽  
Study Groups ◽  
Laboratory Animals ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Laparotomy Wound ◽  
The Impact ◽  
Postoperative Scar

Annotation. One of the main factors of postoperative eventration is intra-abdominal hypertension, which occurs in various surgical pathologies of the abdominal cavity. Despite the presence of a large number of scientific papers on the negative effect of intra-abdominal hypertension on the morphological state of granulation tissue in the area of the laparotomy wound, there are no publications on the impact on the strength of the postoperative scar. Therefore, the study aimed to investigate in an experiment on small laboratory animals the effect of intra-abdominal hypertension on the mechanical strength of the postoperative scar of a laparotomy wound. The experiment was performed on 120 laboratory rats, which underwent a median laparotomy and brought together the edges of the musculoaponeurotic layer of the anterior abdominal wall with simple nodal sutures. The main group consisted of 72 animals who developed intra-abdominal hypertension by inserting a container (condom) with a certain amount of Furacilin into the abdominal cavity. The comparison group consisted of 48 animals who had an empty condom inserted into the abdominal cavity after laparotomy. The mechanical strength of the postoperative scar of the laparotomy wound was determined by the method of G. V. Petrovich (2010) on the 1st, 3rd, and 5th day after the creation of intra-abdominal hypertension, by measuring the level of intra-abdominal pressure at the time of rupture of the postoperative scar of the laparotomy wound. Statistical analysis of the results was performed using Microsoft Excel spreadsheets and a package of statistical processing software PAST. Differences between study groups were determined using Mann-Whitney criteria. The results of the study indicate that the created intra-abdominal hypertension leads to a decrease in the mechanical strength of the postoperative scar of the laparotomy wound. The degree of the negative impact of intra-abdominal hypertension on the strength of the postoperative scar is inversely proportional to the level of intra-abdominal pressure.

scholarly journals The Relation Between the Distance of Rectus Plication and the Intra Abdominal Pressure Changes before and Immediately After Abdominoplasty

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Alshafaai ◽  
H M Omran ◽  
R Z A Lashin ◽  
H K Mohammed
Keyword(s):  
Rectus Sheath ◽  
Abdominal Pressure ◽  
Inclusion Criteria ◽  
Anterior Rectus Sheath ◽  
Rectus Diastasis ◽  
Diastasis Recti ◽  
Healthy Female ◽  
Left And Right ◽  
Pressure Changes ◽  
The Relationship

Abstract Background tummy tuck surgery, also known as abdominoplasty, removes excess fat and skin and, in most cases, restores weakened or separated muscles creating and abdominal profile that is smoother and firmer. Diastasis recti means the belly sticks out because the space between left and right belly muscles has widened. The most notable symptom of anterior abdominal wall weakness or diastasis recti is a noticeable protrusion in the stomach. This protrusion is caused by weakness and separation of the muscles in the mid-abdomen. Objective It was to evaluate the relationship between the distance of recto-fascial or recto-fascial diastasis placation and intra-abdominal pressure changes during and immediately after abdominoplasty. Patient and Methodology In this study we demonstrated if there was relation between rectus diastasis width and the increase of intra-abdominal pressure, to evaluate this correlation before and immediately after the plication of anterior rectus sheath in abdominoplasty. Seventy five meeting the inclusion criteria were selected. Results This study enrolled 75 healthy female patients, the study took place at Al-Jamila Hospital, performed in a period of 10 months, starting from March 2017 till December 2017.

scholarly journals Non-Invasive Intra-Abdominal Pressure Measurement by Means of Transient Radar Method: In Vitro Validation of a Novel Radar-Based Sensor

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 5999
Author(s):  
Salar Tayebi ◽  
Ali Pourkazemi ◽  
Manu L.N.G. Malbrain ◽  
Johan Stiens
Keyword(s):  
Abdominal Wall ◽  
Pressure Gauge ◽  
Urethral Injury ◽  
Abdominal Pressure ◽  
P Value ◽  
Radar Method ◽  
Abdominal Hypertension ◽  
Tract Infections ◽  
Abdominal Compartment

Intra-abdominal hypertension, defined as an intra-abdominal pressure (IAP) equal to or above 12 mmHg is one of the major risk-factors for increased morbidity (organ failure) and mortality in critically ill patients. Therefore, IAP monitoring is highly recommended in intensive care unit (ICU) patients to predict development of abdominal compartment syndrome and to provide a better care for patients hospitalized in the ICU. The IAP measurement through the bladder is the actual reference standard advocated by the abdominal compartment society; however, this measurement technique is cumbersome, non-continuous, and carries a potential risk for urinary tract infections and urethral injury. Using microwave reflectometry has been proposed as one of the most promising IAP measurement alternatives. In this study, a novel radar-based method known as transient radar method (TRM) has been used to monitor the IAP in an in vitro model with an advanced abdominal wall phantom. In the second part of the study, further regression analyses have been done to calibrate the TRM system and measure the absolute value of IAP. A correlation of –0.97 with a p-value of 0.0001 was found between the IAP and the reflection response of the abdominal wall phantom. Additionally, a quadratic relation with a bias of −0.06 mmHg was found between IAP obtained from the TRM technique and the IAP values recorded by a pressure gauge. This study showed a promising future for further developing the TRM technique to use it in clinical monitoring.

Recurrent Abdominal Compartment Syndrome: An Inciting Factor of the Second Hit Phenomenon

2009 ◽  
Vol 75 (12) ◽  
pp. 1193-1198 ◽  
Author(s):  
Juan C. Duchesne ◽  
Catherine C. Baucom ◽  
Kelly V. Rennie ◽  
Jon Simmons ◽  
Norman E. Mcswain
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Wall ◽  
Abdominal Compartment Syndrome ◽  
Hospital Length Of Stay ◽  
Abdominal Pressure ◽  
Abdominal Wall Closure ◽  
Second Hit ◽  
Increased Risk ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Intra-abdominal hypertension (IAH) after damage control laparotomy (DCL) is not unusual and because of this, patients are treated with open-abdomen techniques to prevent abdominal compartment syndrome (ACS). The occurrence of recurrent ACS (R-ACS) after abdominal wall closure under tension in patients managed with DCL can be a trigger factor for second hit syndrome. Outcomes in this subset have not been previously described. In this 1-year retrospective study of severely injured patients in a Level I trauma center managed with DCL and sequential abdominal wall closure, 26 patients were identified. After attempted abdominal wall closure, 13 (50%) patients had R-ACS and 13 (50%) non-R-ACS. R-ACS patients had a statistically significant higher incidence of multisystem organ failure, acute respiratory distress syndrome, and sepsis as well as requiring longer ventilator support and longer hospital length of stay. We concluded that failure to recognize and treat IAH with development of R-ACS after tension abdominal wall closure in patients with DCL will trigger the second hit syndrome with increased risk of morbidity. Institution of a management algorithm with intra-abdominal pressure/abdominal perfusion pressure surveillance at the time of abdominal wall closure can potentially ameliorate complications.

scholarly journals Intra-Abdominal Hypertension and Abdominal Compartment Syndrome after Abdominal Wall Reconstruction: Quaternary Syndromes?

2016 ◽  
Vol 106 (2) ◽  
pp. 97-106 ◽  
Author(s):  
A. W. Kirkpatrick ◽  
D. Nickerson ◽  
D. J. Roberts ◽  
M. J. Rosen ◽  
P. B. McBeth ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Organ Failure ◽  
Abdominal Wall ◽  
Abdominal Compartment Syndrome ◽  
Abdominal Wall Reconstruction ◽  
Abdominal Hernia ◽  
Abdominal Pressure ◽  
Systemic Complications ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Background and Aims: Reconstruction with reconstitution of the container function of the abdominal compartment is increasingly being performed in patients with massive ventral hernia previously deemed inoperable. This situation places patients at great risk of severe intra-abdominal hypertension and abdominal compartment syndrome if organ failure ensues. Intra-abdominal hypertension and especially abdominal compartment syndrome may be devastating systemic complications with systematic and progressive organ failure and death. We thus reviewed the pathophysiology and reported clinical experiences with abnormalities of intra-abdominal pressure in the context of abdominal wall reconstruction. Material and Methods: Bibliographic databases (1950–2015), websites, textbooks, and the bibliographies of previously recovered articles for reports or data relating to intra-abdominal pressure, intra-abdominal hypertension, and the abdominal compartment syndrome in relation to ventral, incisional, or abdominal hernia repair or abdominal wall reconstruction. Results: Surgeons should thus consider and carefully measure intra-abdominal pressure and its resultant effects on respiratory parameters and function during abdominal wall reconstruction. The intra-abdominal pressure post-operatively will be a result of the new intra-peritoneal volume and the abdominal wall compliance. Strategies surgeons may utilize to ameliorate intra-abdominal pressure rise after abdominal wall reconstruction including temporizing paralysis of the musculature either temporarily or semi-permanently, pre-operative progressive pneumoperitoneum, permanently removing visceral contents, or surgically releasing the musculature to increase the abdominal container volume. In patients without complicating shock and inflammation, and in whom the abdominal wall anatomy has been so functionally adapted to maximize compliance, intra-abdominal hypertension may be transient and tolerable. Conclusions: Intra-abdominal hypertension/abdominal compartment syndrome in the specific setting of abdominal wall reconstruction without other complication may be considered as a quaternary situation considering the classification nomenclature of the Abdominal Compartment Society. Greater awareness of intra-abdominal pressure in abdominal wall reconstruction is required and ongoing study of these concerns is required.

scholarly journals The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

2018 ◽  
Vol 8 (6) ◽  
pp. 93
Author(s):  
Ghada Shalaby Khalaf Mahran ◽  
Sayed K. Abd-Elshafy ◽  
Manal Mohammed Abd El Neem ◽  
Jehan A. Sayed
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Body Position ◽  
Critical Issue ◽  
Lateral Position ◽  
Abdominal Pressure ◽  
University Hospitals ◽  
Abdominal Hypertension

Background and objective: Intra-abdominal hypertension (IAH) is a frequent plentiful problem in patients admitted to critical care units. It ranges from a surge incidence of morbidity and mortality to a particular need for nursing health care, so recognition of the occurrence of IAH is a very critical issue for critical care nurses and physician. This study aimed to recognize the effects of various body position with the various head of bed elevation on the intra-abdominal pressure (IAP) in patients with mechanical ventilation.Methods: Design: A non-randomized, prospective observational study was used. Setting: Trauma and general intensive care units at Assuit University Hospitals. Method: In a prospective observational study, during the third day of mechanical ventilation, 60 patients were screened for IAP via a urinary catheter, in two various body positions in three separate degrees of the head of the bed (HOB) elevation (0º, 15º, and 30º). The position was changed at least 4 hours apart over a 24-h period.Results: In lateral recumbence, IAP measurements were significantly elevated compared to supine position, they were 19.70 ± 3.09 mmHg versus 16.00 ± 3.14 (p < .001), 22.80 ± 3.56 mmHg versus 19.03 ± 2.95 (p < .001), and 26.08 ± 3.59 mmHg versus 21.46 ± 2.90 versus (p < .001) at 0º, 15º, and 30º respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0º, 3.8 ± 1.00 mmHg at 15º, and 5.5 ± 1.01 mmHg at 30 º (p < .005).Conclusions: IAP reading is significantly elevated by changing from supine to lateral position especially with HOB elevation and significantly correlated with mortality rate in patients with mechanical ventilation

Transmission of pressure within the abdomen

1996 ◽  
Vol 81 (3) ◽  
pp. 1111-1114 ◽  
Author(s):  
G. E. Tzelepis ◽  
L. Nasiff ◽  
F. D. McCool ◽  
J. Hammond
Keyword(s):  
Fluid Mechanics ◽  
Sigmoid Colon ◽  
Total Lung Capacity ◽  
Hydraulic Model ◽  
Abdominal Pressure ◽  
Lung Capacity ◽  
Pressure Changes

The extent to which transmission of pressure within the abdomen is accomplished in accordance with the laws of fluid mechanics, i.e., homogeneous transmission to all portions of the abdomen, is controversial. To examine the cranial-to-caudal as well as side-to-side transmission of pressure within the abdomen in humans, we measured intra-abdominal pressure at four sites in five subjects undergoing colonoscopy. Liquid-filled catheters were inserted into the colon, and intracolonic pressure was measured in the rectum and in transverse, descending, and sigmoid colon. Differences in intracolonic pressure were recorded during breaths to total lung capacity and brief expulsive maneuvers. Measurements were taken in the supine, right lateral, and seated position. Comparison of pressure swings at all sites showed that the pressure changes were nearly equal during both inspiratory and expulsive maneuvers. The changes in pressure were uniform in the cephalocaudal axis as from side to side. We conclude that transmission of abdominal pressure in humans is nearly homogeneous. Our findings provide support for the hydraulic model of abdominal mechanics.

scholarly journals EFFECT OF THORACIC AND ABDOMINAL PRESSURE CHANGES ON THE EPIDURAL SPACE PRESSURE

1967 ◽  
Vol 39 (8) ◽  
pp. 612-618 ◽  
Author(s):  
JOSE E. USUBIAGA ◽  
FRANK MOYA ◽  
LILIA E. USUBIAGA
Keyword(s):  
Epidural Space ◽  
Abdominal Pressure ◽  
Thoracic And Abdominal ◽  
Pressure Changes
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