Comparison of Decellularized Bubaline Diaphragmatic Scaffold with Synthetic Polygalactin and Polypropylene Composite Mesh for Perineal Hernioplasty in Dogs

Present study was planned to compare xenogenic decellularized bubaline diaphragmatic scaffold with synthetic polygalactin and polypropylene composite mesh for repair of perineal hernia in dogs. Twelve dogs suffering with perineal hernia were randomly divided in to two equal groups. In group I perineal hernioplasty was done with Synthetic polygalactin and polypropylene composite mesh while in group II, with decellularized bubaline diaphragmatic scaffold (dBDS). Mean surgical time was 59.17 ± 14.04 and 57.50 ± 6.15 minute in group I and II respectively. Swelling, redness and warmth increased significantly (p<0.05) on day 3 in both the groups. In group II initially significantly (p<0.05) increased exudation was observed on day 3 which reduced gradually. Degree of pain after surgery was significantly (P<0.05) decrease on day 3 in both the groups. Neutrophil count was significantly (p<0.05) increased and correspondingly lymphocyte count significantly (p<0.05) decreased on day 7 in group I while in group II no significant difference within the group was observed. Colour Doppler ultrasonographic examination revealed no vascularization on 0 day in both the groups. Neovascularization was observed on day 30 in group I and day 14 in group II on Colour Doppler ultrasonographic examination. It was increased on day 90 in both the groups. The complication encountered in the present study includes local seroma, suture dehiscence due to self mutilation, constipation and fistula formation. Decellularized bubaline diaphragmatic scaffold was well accepted by all the animals and showed less complication than synthetic mesh

Effects of flap or myocutaneous flap combined with fascia lata or composite mesh on repairing severe high-voltage electrical burn wounds in abdomen of patients / 中华烧伤杂志

Objective@#To investigate the effects of flap or myocutaneous flap combined with fascia lata or composite mesh on repairing wounds in abdomen of patients with severe high-voltage electrical burn.@*Methods@#From January 2010 to May 2017, 11 patients with severe high-voltage electrical burn in abdomen were hospitalized in our burn wards. In 3 hours to 7 days after burn, operation was performed when patients were in stable condition. After debridement, intestines with necrosis or perforation in 4 patients with peritoneal defects were resected and intestinal anastomosis was performed. The size of abdominal wounds after debridement ranged from 13 cm×9 cm to 41 cm×32 cm. Five patients were treated with rectus abdominis myocutaneous flap and size of which ranged from 14 cm×10 cm to 30 cm×17 cm. Among the above 5 patients, 4 patients with peritoneal defects used composite mesh of 25 cm×20 cm to enhance abdominal wall. Three patients were treated with tensor fascia lata myocutaneous flap, and size of the flap ranged from 24 cm×10 cm to 27 cm×13 cm. Three patients were treated with anterolateral thigh flap with fascia lata, and one of them was treated with the lobulated flap; size of the flap ranged from 18 cm×13 cm to 25 cm×15 cm. The later 6 patients used fascia lata of flap to enhance abdominal wall. The donor sites were sutured directly or repaired with intermediate split-thickness skin graft of thigh.@*Results@#After operation, flaps or myocutaneous flaps of patients were survived, and strength of abdominal wall recovered. During follow-up of 6 month to 1 year, flaps or myocutaneous flaps were in good appearance, with no ankylenteron or abdominal wall hernia.@*Conclusions@#Flap or myocutaneous flap combined with fascia lata or composite mesh can achieve good effects on repairing severe high-voltage electrical burn wounds in abdomen.

Técnica quirúrgica y resultados a corto plazo de la hernioplastía incisional intraperitoneal abierta / SurgicaI technique and short-term outcomes of open intraperitoneal incisional hernioplasty

Introduction: A review of current literature failed to find any detailed description on the surgical technique of open intraperitoneal mesh hernia repair. The aim of the present study was to describe the open surgical technique used at our institution to repair incisional hernias with intraperitoneal composite prosthesis, and the short-term outcomes including recurrence, complications and patient satisfaction with the procedure. Patients and Methods: A transversal, observational and descriptive report on open intraperitoneal hernioplasty was designed. Short-term outcomes were assessed at a transversal cut out point at a 12-month interview during the follow-up. The interview included a physical exam and a specific questionnaire inquiring over the patient's satisfaction with the procedure. Results: According to the inguinal ring location, most hernias originated between the xiphoid appendix and the umbilicus (64 percent). Mean surgical time was 2.6 hours. One or more complications presented in 11 patients (19 percent). One year after surgery there was not any recurrence. According to the patient' satisfaction questionnaire final score, 17 patients (29 percent) reported an excellent satisfaction with the procedure, 33 patients (57 percent) reported a very good satisfaction and 8 patients (14 percent) a good satisfaction. Conclusions: Intraperitoneal hernioplasty constitutes a secure option to repair incisional hernias. At short-term follow-up there were no recurrences.

Introducción: No se encuentra en la literatura ninguna descripción detallada de Ia técnica para instalación de prótesis intraperitoneales por vía abierta. El objetivo del presente estudio es describir la técnica que utilizamos en nuestra institución y Ios resultados a corto plazo de estas operaciones: recurrencia, complicaciones y satisfacción del usuario con el procedimiento. Pacientes y Método: El presente es un reporte transversal, observacional y descriptivo de la técnica de Ia hernioplastía intraperitoneal abierta y de los resultados iniciales de esta técnica tomando como punto de corte transversal el control de los 12 meses de seguimiento. El control incluyó una entrevista, examen físico y un cuestionario específico sobre satisfacción con el procedimiento. Resultados: De acuerdo a la localización del anillo herniario, la mayoría de las hernias se originaron entre la cicatriz umbilical y el apéndice xifoides (60,4 por ciento). El tiempo quirúrgico promedio fue 2,6 horas. Se presentaron una o más complicaciones en 11 pacientes (19 por ciento). Un año después de la cirugía no se encontró ninguna recurrencia. De acuerdo a la puntuación final del cuestionario de satisfacción usuaria, 17 pacientes (29 por ciento) reportaron una satisfacción excelente con el procedimiento, 33 pacientes (57 por ciento) una satisfacción muy buena y 8 pacientes (14 por ciento) una satisfacción buena. Conclusiones: La hernioplastía intraperitoneal constituye una opción segura para la reparación de hernias incisionales. En el seguimiento a corto plazo no presenta recurrencias.

Laparoscopic repair of giant hiatal hernia: analysis of 25 cases / 中华胸心血管外科杂志

Objective To investigate the clinical characteristics and feasibility of laparoscopic repair of giant hiatal hernia. Methods From January 2008 to August 2010, 25 consecutive patients with giant hiatal hernia underwent laparoscopic repair. Crural closure was performed by means of two or three interrupted nonabsorbable sutures plus a tailored PTFE/ePTFE composite mesh. It was patched across the defect and secured to each crura with staples. Laparoscopic fundoplication was performed concomitantly in 16 cases according to the specific conditions of patients. Para-operative clinical parameters were recorded. All patients were routinely followed up. Clinical outcomes were collected and analyzed. Results All laparoscopic surgeries were accomplished successfully. The operating time was 85 -210 minutes (mean, 106 minutes) ,the operative blood loss was 55 - 150 ml( mean, 94 ml) ,the postoperative hospital stay was 4 -21 days( mean, 6.8 days). The symptoms in most cases were adequately relieved after operation. There was no severe postoperative morbidity. After the follow-up period of 3 - 35months ( mean, 13.6 months), the satisfaction rate of surgery was 88%. 4 cases had mild symptom recurrence of acid reflux.Hiatal hernia recurrence occurred in 1 case. Conclusions Laparoscopic repair of giant hiatal hernia is a safe and effective minimally invasive procedure, with the advantages of minimized trauma, quick recovery and reliable effect. The use of a tailored PTFE/ePTFE composite mesh ( Bard CruraSoft Mesh)for giant hiatal hernia proved to be effective in reducing the operation time and technique demands, and the rate of postoperative hernia recurrence, with a very low incidence of mesh-related complications.

Laparoscopic repair of abdominal wall incisional hernia:A report of 41 cases / 中国微创外科杂志

Objective To investigate effects of laparoscopic repair of abdominal wall incisional hernia using polypropylene and expanded polytetrafluoroethylene(e-PTFE) composite mesh. Methods Forty-one patients with abdominal wall incisional hernia(4~25 cm in length and 3~18 cm in width) were treated in this hospital from October 2004 to August 2005. The patients received laparoscopic mesh herniorrhaphy after complete dissection of adhesion using an ultrasonic scalpel.A polypropylene and(e-PTFE) composite mesh(Bard Composite Mesh) was used and fixed using the Ethicon Endopath Multifeed Stapler(EMS).Results The laparoscopic mesh herniorrhaphy was successfully completed in all the 41 patients without conversions to open surgery.The operative time was 60~182 min(mean,85 min).Postoperatively,the patients felt slight pain and began to take food on the second day.The time to first passing flatus was 25~41 hours(mean,32 hours).The postoperative hospital stay was 5~7 days(mean,6 days).No recurrence occurred during a follow-up period of 6~16 months(mean,9 months) in the 41 patients. Conclusions The laparoscopic incisional hernia repair using the Bard Composite Mesh is a safe and effective method.

Ventral incisional hemiorrhaphy with intraperitoneal composite mesh:a report of 10 cases / 中国普通外科杂志

Objective To retrospectively review the results of intraperitoneal placement of composite mesh for the repair of ventral incisional hernia. Methods Ten patients, in which the peritoneum was difficult to close direcdy, underwent repair of ventral incisional hernia with composite mesh between November 2003 and June 2005. The mesh was placed intraperitoneally. The mean duration of follow-up was 18 months (range 6 to 24). Results All the patients (10/10) were cured without postoperative complications such as wound infection, subcutaneous seroma and hematoma. During the follow-up study, no recurrences was observed. There were no long-term complications, such as bowel obstruction, fistula formation and fistulization to the small bowel. All the 10 patients felt comfortable. Conclusions Intraperitoneal placement of composite mesh is a safe and effective repair method for ventral incisional hernia.