[The method of non-tension plastic surgery of median postoperative hernias].
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Biomedical subjects
Publications and source records attributed to M S Deriugina.
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The developed method of plastic repair of anterior abdominal wall's vast defects is intended for use in reconstructive-plastic herniology for closure in layers of total defects of the abdominal wall without reduction of abdominal cavities volume, in oncology and traumatology--for repair of abdominal wall's integrity after excision of massive tumors or damaged tissues. In correction by this method of large muscular-aponeurotic defects of abdominal wall the own tissues of the patient (greater omentum, hernial sac) and lavsan explants of author's construction are used maximally. New abdominal white line is formed, all the loted or insufficient tissues of abdominal wall are replaced. 88 patients with defects of anterior abdominal wall of different origin were operated by this method. Long-term results were followed up for 11 years, there was no recurrence, in 3 patients moderate relaxation in the area of hernioplasty was revealed, due to nonobservance of recommendations in early postoperative period. Patients with large hernias and defects of anterior abdominal wall should be operated in specialized surgical clinics.
The author describes her original method of operative treatment of patients with diastasis of the rectal muscles of the abdomen intended for liquidation of divarication of recti, formation of the new white line and strengthening of incompetent aponeurotic formations of the abdominal wall with the help of lavsan explants. The method was successfully used in 73 patients with long-standing complex diastasis of the rectal muscles of the abdomen. The average age of the patients was 45.9 years. The long-term results were followed up during the period from 1 to 11 years. No recurrences were noted. Three patients had mild relaxation of the lateral muscles of the abdomen, so they have to use elastic bandages and to fulfill feasible work.
New pathogenetically substantiated method of operative treatment for complicated inguinal hernias has been developed by the author (patent R.F. No 2007128) and used in clinical practice. It provides to restore anatomo-topographic and functional parameters of the inguinal channel, to eliminate traumatic effect of the operation and to decrease the risk of recurrence of the disease. The method consists in correction of the walls of the inguinal channel by (-shaped goffered sutures from polymerous monothreads, on which frame a reliable regenerate connective tissue is being developed. This method was used in 97 patients with large complicated inguinal hernias. 1-5 year follow-up results has been studied. There were no relapses of the disease. By virtue of the simplicity of this method and its efficacy it is accessible for great majority of surgeons.
The author studied in 311 women long-term results of treatment of giant hernias, that were caused by urgent (52.4%) and planned (47.6%) obstetric and gynecologic operations. The original lavsan prostheses were used to cover the suprapubic abdominal wall defects that provided good long-term results with no cases of relapses, good functional and cosmetic effects, and complete restoration of capacity for work.
The results of 473 hernioplastic operations performed in 397 patients with complex inguinal hernia within the period of from 1958 to 1988 have been analysed. In followup of from 2 to 30 years, 3 (0.75%) patients developed a disease recurrence because of errors in technique of kapron plasty of the anterior wall of the inguinal canal. From 1970, in the clinic for plasty of complex inguinal hernia, a coarse mesh lavsan prosthesis of the own construction has been used. There were no disease recurrences.
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