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At least 37 records · Page 2Linked to original sources
PubMed1993

Fetal abdominal wall defects.

Abdominal wall defects are frequently detected prenatally. Optimal management requires identification of the type of lesion and a careful search for associated chromosomal and structural anomalies. For cases with lethal associated abnormalities, elective termination may be offered. Preterm delivery should be considered for fetuses with gastroschisis who have evidence of ongoing intestinal damage, as evidenced by bowel dilatation and thickening, although objective selection criteria are still being developed. There is currently no convincing evidence to support routine cesarean delivery in fetuses with abdominal wall defects. Most infants with abdominal wall defects should be born at a perinatal center, where neonatal and surgical expertise is immediately available. In every case, prenatal diagnosis should lead to parental counseling and decision-making by a multidisciplinary team consisting of obstetricians, neonatologists, and pediatric surgeons.

Abdominal Muscles↗
PubMedDate not supplied

[Surgical tactics in abdominal wall neoplasia].

Abdominal wall neoplasms represent more or less 1% of human neoplasms in the adult. The authors reports their own experience based on 9 cases during over 20 years. The prognosis of these tumors is almost influenced from a lot of factors such as: histology, localization, staging, grading, sex, surgical margins, number of local recurrences. Abdominal wall neoplasm are less aggressive for compartmentalization of muscle layer and with a better prognosis because of their localization, and surgical opportunities of extensive resection (not less of 2 cm from tumor's macroscopic limits) allowed by modern prosthetic reconstruction techniques. Polipropilene seems to be the ideal material for such kind of reconstruction even if also mersilene, PTFEe and others were employed. PTFEe and Dual-meshes could be useful in those malignant tumors in which peritoneum resection is necessary.

Abdominal Neoplasms↗
PubMed2004

Component separation in the management of the difficult abdominal wall.

BACKGROUND: Abdominal compartment syndrome (ACS) and mesh implantation in abdominal wounds are creating abdominal wall problems not seen in the past. Component separation (CS) is an alternative technique used to manage these difficult wounds. METHODS: From January 2001 to July 2003, 27 patients were identified who had undergone CS. Charts were reviewed for defect etiology and characterization, surgical results, and outcome from reconstruction. RESULTS: Etiology of the defect was ACS in 14, infected mesh in 5, and multiple failed repairs in 8 patients. Twenty-three were closed completely with CS, 2 required prosthetic mesh, and 2 had a porcine implant placed. Three wound complications occurred that required reoperation. Three hernia recurrences have been identified. All patients are completely recovered and are currently functioning without limitation. CONCLUSIONS: Large and/or complex abdominal wall defects can be managed with a single-stage procedure using CS, thus many complications associated with implantation of prosthetic mesh are avoided. Functional outcome is excellent.

Abdominal Wall↗
PubMedDate not supplied

Carcinoma of sigmoid colon presenting as abdominal wall abscess.

Abdominal wall abscess is a rare presentation of intra-abdominal disease. We describe a 69-year-old woman with a locally advanced carcinoma of the sigmoid colon presenting as abdominal wall abscess. The diagnosis was suggested by computed tomography of the abdomen. She was treated with resection of the tumor with closure of the rectal stump and proximal end colostomy. No adjuvant therapy was undertaken considering the extent of the disease. She survived for four months after the operation.

Abdominal Abscess↗
PubMed1994

The use of Mitek anchors to secure mesh in abdominal wall reconstruction.

Abdominal wall complications of TRAM flap breast reconstruction are well described. Synthetic mesh abdominal reinforcement is believed to decrease the incidence of these complications. An innovative technique with commonly available suture anchors has been used in a case of recurrent abdominal laxity after a TRAM flap. Osseous fixation of synthetic mesh with the Mitek GII suture anchor will undoubtedly be used more widely in abdominal wall reconstruction.

Abdominal Muscles↗
PubMed1984

[Plastic surgery of the abdominal wall].

An abdominal wall rich of fat or relaxed and poor of fat could be burdensome psychically and physically, especially if there are additional changes of musculoaponeurotic abdominal wall. The line of incision for abdominoplasty (cross-ellipse, anchor, star, Pitanguy) depends on age, on obesity and on private wishes of patients. In the restauration of the myoaponeurotic part the abolition of distance between the rectus muscles takes the first place. It will be followed by fastening ciatric hernias, in single cases umbilical or inguinal hernias. A considerable relaxation sometimes forces stretching of the myoapneurotic part, too. Postoperative care must be carefully, to avoid complications in wound healing and above all thromboembolism.

Abdominal Muscles↗
PubMed1996

Abdominal wall hernias.

Abdominal wall hernias are usually asymptomatic, discovered incidentally on physical examination. Emergency physicians, however, may be called on to deal with the potential life-threatening complications of abdominal wall hernias. This article discusses the anatomy, pathophysiology, and specific types of hernias in the adult and pediatric patient populations. Also covered are the complications of hernias, emergency interventions for hernia reduction, and urgent surgical consultation.

Diagnosis, Differential↗
PubMed2000

The role of tissue expansion in abdominal wall reconstruction.

Abdominal wall reconstruction of ventral hernia defects with loss of visceral domain and inadequate soft-tissue coverage presents a surgical challenge. Four patients with large, skin grafted ventral hernia defects were treated by staged abdominal wall reconstruction. During the initial stage, tissue expanders were placed under the skin and subcutaneous tissue lateral to the defects. After adequate interval expansion, the second stage was performed. The expanders were removed, the visceral contents reduced easily, and the fascia reapproximated with polypropylene mesh. The expanded skin was closed easily over the fascial repair. All four patients were reconstructed successfully without complications. Tissue expansion can restore abdominal domain and allow soft-tissue closure in complicated ventral hernia defects.

Abdominal Muscles↗
PubMed2002

Massive ventral hernias: role of tissue expansion in abdominal wall restoration following abdominal compartment syndrome.

Massive ventral hernias may result from a variety of clinical situations. One such clinical situation, a common problem in trauma patients, is abdominal compartment syndrome. Abdominal compartment syndrome frequently results in a massive abdominal defect when primary closure after surgical decompression is not possible. We offer a technique for repairing these massive ventral hernias by first expanding the lateral abdominal wall muscles, fasciae, and skin with tissue expanders and then closing the defect with elements of the "components separation" method. Additionally we present other clinical situations resulting in a massive ventral hernia that were repaired using this technique.

Abdomen↗
PubMed1979

[Reconstruction of abdominal wall defects using corium. Surgical procedure, clinical results and manometric examination of postoperative abdominal wall function].

Extensive resection of the abdominal wall was performed on six patients to reconstruct defects caused by tumors or necroses. Autologous dermis covered by a flap plasty produced good clinical and functional results, documented by the measurement of intraabdominal pressures in response to coughing, pressing, and lifting of the legs. The autologous dermis graft represents a valuable tool for the closure of large defects of the abdominal wall.

Abdominal Muscles↗
PubMed2005

Reduction of abdominal wall blood flow by clamping or carbon dioxide insufflation increases tumor growth in the abdominal wall: an experimental study in rats.

BACKGROUND: We have previously demonstrated that there is a reduction of blood flow in the abdominal wall in rats insufflated with air concomitant with an increase in tumor growth. The present study was designed to examine whether a reduction of blood flow achieved by clamping or insufflation with carbon dioxide (CO(2)) would increase tumor growth in the abdominal wall. METHODS: In the first part of the experiments, laser Doppler blood flow of both rectus muscles was measured in 16 Wistar Fu rats. The left rectus muscle was clamped to reduce blood flow, and 5 x 10(4) adenocarcinoma cells were injected into both rectus muscles. Clamping was maintained for 45 min. In the second part, 22 rats had 5 x 10(4) adenocarcinoma cells injected into the rectus muscle and blood flow was measured. The experimental group (n = 11) was insufflated with CO(2) at 10 mmHg for 45 min; the control group (n = 11) was not insufflated. After 9 days, tumor weight and volume were analyzed. RESULTS: Clamping caused a 69% reduction of blood flow (p < 0.001), whereas no reduction was registered on the nonclamped side. Tumor weight (p = 0.028) and volume (p = 0.030) were increased on the clamped side. The insufflation of CO(2) caused a 71% reduction of blood flow, whereas no reduction was registered in the control group. Tumor weight (p = 0.006) and volume (p = 0.006) were increased in the insufflated group. CONCLUSION: Clamping, as well as CO(2) insufflation, causes a significant reduction of blood flow in the abdominal wall, which seems to increase tumor growth at the same site.

Abdominal Neoplasms↗
PubMed1984

Abdominal wall competence in transverse abdominal island flap operations.

This study critically evaluates the abdominal wall in 82 patients following breast and chest wall reconstruction using the transverse abdominal island flap operation. Experience with these patients led to an awareness of the important muscle and ligamentous structures in the anterior abdominal wall. An operative procedure is presented for selective harvesting of the transverse abdominal island flap in a manner that preserves viability of the flap and at the same time reestablishes abdominal competence.

Abdominal Muscles↗
PubMed1987

One-stage abdominal wall reconstruction with oblique abdominal fasciocutaneous flaps.

The coverage of large soft-tissue defects of the abdominal wall resulting from ablative surgery continues to be a challenging problem. Numerous flaps have been used, but flaps have their limitations in size and as well as arc of rotation, and often require skin grafting of the secondary donor site. Thus, a combination of flaps may be required to close some of the larger defects without resorting to the use of skin grafts. This article reports a patient with an ulcerated abdominal wall tumor defect reconstructed with oblique abdominal fasciocutaneous flaps. Two flaps based on superior and inferior epigastric perforators were contoured to fit the massive defect in one stage without using a skin graft. After surgery the flap healed uneventfully and the patient was discharged from the hospital. She is now undergoing irradiation therapy in an outpatient clinic.

Abdominal Muscles↗
PubMed2004

Traumatic handlebar hernia: a rare abdominal wall hernia.

Traumatic abdominal wall herniation (TAWH) caused by direct trauma from bicycle handlebars are rare. There are only 21 reported cases of handlebar hernias. An 11-year-old boy presented to the emergency room soon after falling from his bicycle and hitting his right lower quadrant on the handlebars. The patient's vital signs and initial laboratory studies were normal. Physical exam showed a soft tissue bulge in the right lower quadrant with superficial ecchymosis and tenderness to palpation. Computed tomography showed intestinal loops protruding through a defect in the abdominal wall into the subcutaneous space. Surgical exploration found a defect throughout his entire abdominal wall including the fascia, muscular layers, and peritoneum, with bowel protruding into the subcutaneous space. The defect was repaired in layers, and the child's postoperative course was unevenful. The authors recommend a high level of clinical suspicion for TAWH in all patients with traumatic abdominal wall injuries. Definitive treatment includes surgical exploration with primary repair of all tissue layers of the abdominal wall.

Abdominal Injuries↗
PubMed1997

[The use of mesh in abdominal wall defects].

Today abdominal wall defect repair can't prescind from the use of prosthetic materials. Inguinal, femoral and incisional hernias represent more frequent events in which, only using prosthetic materials is it possible to perform "tension-free" repair. Prosthetic repairs "agree with" abdominal, wall physio-pathology, guarantee results and prevent recurrences. Permanent biomaterials like polypropylene and dacron mesh deserve special attention for their distinctive features are suitable for abdominal wall defect repair. Selection of material is an important step according to surgical technique and to avoid complications; the most alarming of which is a possible infection. However the average incidence of infection on prosthesis is about 0.5%. While infection risk is really scarce, the benefits of prosthetic repairs are clear: the recurrence rate of traditional hernia repairs is about 33% and 0-0.7% in prosthetic repairs. Likewise the recurrence rate for traditional incisional hernia repair is between 14% and 50%, whereas in prosthetic repairs it is 0-4.5%. Therefore it is necessary to use prosthesis for the following two reasons: firstly to avoid tension on the suture line, the prime cause of recurrence, and secondly to increase formation of collagen fibres on the transversalis fascia that appears histologically and biochemically altered. The authors report their experience of 660 prosthetic repairs, 600 for hernia and 60 for incisional hernia, performed, in the period April 1992-December 1994, at the General Surgery Department in San Giovanni Valdarno Hospital. The surgical techniques used were "tension-free" and "sutureless" and the prosthesis laid down always a polypropylene mesh. Complications only occurred in 33 patients, particularly 4 cases of infection (0.6%) however mesh remove was not required. The follow-up until today evidenced only two early recurrences owing to our technical mistakes in the beginning of our experience. For incisional hernia repair we laid down a giant dacron mesh on preperitoneal space. No complications were registered. The average stay in hospital was 5 days and follow-up showed no recurrence. The use of prosthetic materials in abdominal wall defect repair expressed large benefits with evident and clear reduction in recurrence rate. Traditional techniques produce tension on the suture line and high percentage of early and late recurrences since an essential surgical principle is transgressed. In fact traditionally repair has been accomplished by approximation of anatomical structures, that are not normally in apposition and by utilization of defective tissue. Metabolic alteration involving collagen turnover is evident in these patients. The answer to this problem is prosthetic repair. At present there is no ideal prosthesis, however the surgeon can use several suitable synthetic materials. The selection of prosthetic materials is a fundamental step also considering the possible infection; that however develops rarely. In conclusion the authors think that mesh repairs represent an overcoming of traditional surgical techniques in abdominal wall defect repair.

Abdominal Muscles↗