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At least 55 records · Page 3Linked to original sources
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↗
PubMed2006

[Primary endometriosis of the abdominal wall: an entity to be included in the differential diagnosis of abdominal wall masses].

Endometriosis consists of the presence of extrauterine endometrial tissue. It is usually localized in the pelvis, although it can also be found in other sites. Cutaneous localization is unusual and the most frequent form appears on scars from obstetric or gynecological interventions. It can, however, develop spontaneously, especially in umbilical or inguinal areas and can be confused with irreducible hernias or granulomas. We present the cases of three patients with spontaneous endometriotic nodules of the abdominal wall. The lesions were located in the umbilical region in two patients and in the suprapubic area in one. In two patients clinical suspicion led to preoperative diagnosis, although diagnosis is usually established after histopathological analysis of the surgical specimen.

Abdominal Wall↗
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↗
PubMed1993

Reconstruction of the abdominal wall with a latissimus dorsi musculocutaneous flap: a case of a massive abdominal wall metastasis from a cervical cancer requiring palliative resection.

A 49-year-old woman presented with a huge abdominal mass. At laparotomy, a 36-cm diameter semisolid, semicystic mass from the abdominal wall was removed. The peritoneal defect was covered by a mesh and a free latissimus dorsi myocutaneous flap. Histology showed a poorly differentiated squamous cell carcinoma consistent with metastatic tumor from a cervical primary. Surgery has a finite palliative role to extirpate a tumor mass of this size if reconstruction and some form of closure can be achieved.

Abdominal Muscles↗
PubMed2006

Abdominal wall reconstruction after temporary abdominal closure: A ten-year review.

Abdominal wall reconstruction (AWR) is often required for hernias created after temporary abdominal closure (TAC). Demographic and clinical data from patients undergoing TAC and AWR between January 1, 1992, and December 31, 2002, were collected and univariate analysis performed. Temporary abdominal closure and AWR were performed in 21 patients. Complications developed in 12 patients (57.1%) after TAC; associated risk factors were mesh placement (P = .04) and skin grafting (P = .04). Successful AWR included mesh (n = 6), component separation (n = 6), primary repair (n = 4), and 3 combination techniques. Six patients (28.6%) developed intraoperative complications, and 14 (66.7%) developed postoperative complications. Intraoperative complications were increased in patients with tissue expanders (P = .01). Postoperative complications (P = .04) were less likely with component separation. The complication rate with TAC and AWR is high. Tissue expanders are associated with an increased risk of intraoperative complications with AWR, whereas component separation is associated with a reduction in postoperative complications.

Abdominal Wall↗
PubMed2005

Multidisciplinary approach to abdominal wall reconstruction after decompressive laparotomy for abdominal compartment syndrome.

INTRODUCTION: Decompressive laparotomy for abdominal compartment syndrome has been shown to reduce mortality in critically ill patients, but little is known about the outcome of abdominal wall reconstruction. This study investigates the role of plastic surgeons in the management and reconstruction of these abdominal wall defects. METHODS: We performed a retrospective review of 82 consecutive critically ill patients who underwent decompressive laparotomy for abdominal compartment syndrome, at a university level 1 trauma center, from April 2000 to May 2004. Patients reconstructed by trauma surgeons alone (n = 15) were compared with patients reconstructed jointly with plastic surgeons (n = 12), using Student t test and chi analysis. RESULTS: Eighty-two patients underwent decompressive laparotomy for abdominal compartment syndrome, yielding 50 survivors (61%). Of the 27 patients who underwent abdominal wall reconstruction, 6 had early primary fascial repair, and 21 had staged reconstruction with primary fascial closure (n = 4), components separation alone (n = 3), components separation with mesh (n = 10), or permanent mesh only (n = 4). Compared with patients whose reconstruction was performed by trauma surgeons, patients who underwent a combined approach with plastic surgeons were older (50.5 versus 31.7 years, P < 0.05), had more comorbidities (P < 0.001), were less likely to have a traumatic etiology (P < 0.001), had a longer delay to reconstruction (407 versus 119 days, P < 0.05), and were more likely to undergo components separation (P < 0.05). Mean follow-up of 11.5 months revealed 2 recurrent hernias in the combined reconstruction group, both of which were successfully repaired. CONCLUSIONS: A multidisciplinary approach is essential to the successful management of abdominal wall defects after decompressive laparotomy for abdominal compartment syndrome. Although carefully selected patients can undergo early primary fascial repair, most of reconstructed patients had staged closure of the abdominal wall via components separation, with a low rate of recurrent hernia. High-risk patients with large defects and comorbidities appear to benefit from the involvement of a plastic surgeon.

Abdomen↗
PubMed2003

Evisceration through multiple abdominal wall defects following blunt abdominal injury.

We report an unusual case of a posttraumatic evisceration of small and large bowel through 2 holes in the anterior abdominal wall after a motor vehicle accident. Prompt adequate management consists of reestablishing the perfusion of the eviscerated organ if the blood supply is compromised, performing a full laparotomy to exclude intra-abdominal organ injury and meticulous cleaning of the eviscerated organs before reducing them in the abdomen and closing the abdomen in layers.

Abdominal Injuries↗
PubMed2003

Spontaneous endometriosis of the abdominal wall.

BACKGROUND: The abdominal wall is the commonest site of extrapelvic endometriosis, which usually develops in association with a prior surgical scar. CASE: A 28-year-old woman with two endometriomas in the recti abdominis, which developed in a scarless abdomen. CONCLUSIONS: Abdominal wall endometrioma can develop spontaneously in the absence of prior surgical scar and should be considered in the differential diagnosis of abdominal wall masses.

Abdominal Wall↗
PubMedDate not supplied

Abdominal wall hernias after open abdominal aortic aneurysm repair: prospective radiographic detection and clinical implications.

The purpose of this study was to evaluate the prevalence of radiographically detected abdominal wall defects (AWD) after open abdominal aortic aneurysm (AAA) repair and to correlate it with prospectively gathered clinical information. Fine collimation, high-resolution, serial follow-up computed tomography (CT) scans for 99 patients in the control group of the Guidant Ancure device trial were reviewed. CT scans were obtained at 12, 24, 36, 48, and 60 months. AWDs, defined as discontinuity of the fascial layer with protrusion of abdominal contents, were identified. Clinical information regarding AWDs was retrieved from the study registry. The prevalence of AWD exceeds 20% and plateaus at 24 months. Eight patients (8%) had clinical evidence of ventral incisional hernias. One patient underwent repair, but no other patient developed hernia incarceration or intestinal obstruction or required additional procedures related to the AWD. AWDs are radiographic findings occurring frequently after open AAA repair. Radiographic evaluation is more sensitive than clinical observation for detection of ventral hernias. Clinical events and reinterventions related to these radiographic abnormalities are rare.

Aortic Aneurysm, Abdominal↗
PubMed2000

An algorithm for abdominal wall reconstruction.

Acquired abdominal wall defects result from trauma, previous surgery, infection, and tumor resection. The correction of complex defects is a challenge to both plastic and reconstructive and general surgeons. The anatomy of the abdominal wall, as well as considerations in patient assessment and surgical planning, are discussed. A simple classification of abdominal wall defects based on size, depth, and location is provided. Publications regarding the various abdominal reconstruction techniques are reviewed and summarized to familiarize the reader with the treatment options for each particular defect. Finally, an algorithm is presented to guide the surgeon in selecting the optimal reconstructive technique.

Abdominal Muscles↗
PubMed1988

The extended latissimus dorsi flap in repair of anterior abdominal wall defects.

Large abdominal wall defects (ventral hernias) can be difficult to repair. Some defects are not amenable to primary repair or the use of synthetic mesh because of repeated recurrence or wound infection. In complicated situations such as that mentioned above, the extended latissimus dorsi muscle flap has been used to repair upper and middle abdominal wall defects. This method has been utilized in six patients, and there has been no recurrence of the defect or evidence of a lumbar hernia. The follow-up has been from 7 to 66 months. The extended latissimus dorsi muscle flap has proven to be an excellent alternative in the repair of complicated abdominal wall defects.

Abdominal Muscles↗
PubMed1992

The abdominal wall. A frequently overlooked source of abdominal pain.

Here, I review various conditions from my practice as a consultant gastroenterologist that present with abdominal pain in which the cause of the pain is the result of abdominal wall conditions, or disorders that affect the nerves to the abdominal wall. The diagnosis of abdominal wall pain can be made by careful history and physical examination, thus eliminating numerous unnecessary and sometimes dangerous invasive procedures and tests.

Abdominal Muscles↗