The use of dermal automesh for incidental hernia repair in abdominoplasty: Clinical, biochemical, and radiological results.

Abdominal wall hernias are often diagnosed on clinical examination or encountered intraoperatively during an abdominoplasty. The aim of this study is to evaluate the long-term results of the use of dermal automesh for the repair of incidental hernias during abdominoplasty operations, and to perform a comparative analysis of the biomechanical strengths of dermal automesh vs biological tissue graft. Between 2008-2012, dermal automesh was used in 12 patients for hernia repair. After repair of hernia, dermal automesh was applied over the repaired area in an onlay fashion. Postoperative follow-up was performed by physical examination and magnetic resonance imaging (MRI) of the abdominal wall. Biomechanical test was performed with prepared samples from excised abdominal panniculus for tensile strength and yield power. Mean age was 45 years (range = 36-54 years). Total follow-up was 26 (14-52) months. MRI studies showed that there were no hernias or defects of the anterior abdominal wall. The tensile strength of the dermal mesh was measured as 15.9 ± 6.0 Mpa (6.4-24.5), maximum load before yield measured 680 ± 175.2 N (336.0-856.0). In conclusion, dermal automesh is a useful option for surgeons who encounter undiagnosed hernias during abdominoplasties.

Atraumatic Flexor tendon retrieval- a simple method.

BACKGROUND: Zone 2 flexor tendon injuries still represent a challenging problem to hand surgeons despite the well developed surgical techniques and suture materials. Meticulous surgical repair with atraumatic handling of the severed tendon stumps and minimal damage to the tendon sheath are particularly important to prevent postoperative adhesions and ruptures in this area.In zone 2 flexor tendon injuries proximal to the vinculas, the cut ends of the flexor tendons retract to the palm with muscle contraction. To retrieve the severed proximal flexor tendon under tendon sheath and pulley system is very difficult without damaging these structures. Many techniques are described in the literature for the delivery of the retracted proximal tendon stump to the repair site. METHODS: In this report we would like to present a simple and relatively atraumatic technique that facilitates passing of the retracted flexor tendon through the pulleys in zone 2. We sutured the proximal tendon stump at the distal palmar crease with 3-0 polypropylene suture and used a 14 gauge plastic feeding tube, acting like a conduit for the passage of straightened needle to the finger. RESULTS: We have used this technique 21 times without any complication in our clinic. We have not seen any suture breakage during the passage or needle breakage due to the bending of the needle. CONCLUSIONS: We have found this technique is very simple and very effective in retrieving the retracted tendon stump without causing undue damage to the tendon stump or tendon sheath.

Ocular complication after trichloroacetic acid peeling: a case report.

UNLABELLED: Chemical peeling is a noninvasive technique currently used more frequently as a cosmetic procedure. Trichloroacetic acid (TCA) is one of the most popular chemical agents used for this purpose Stuzin et al. (Clin Plast Surg 20:9-25, 1993). Although this application commonly is used for the whole face, including the eyelids, the data in the literature referring to ocular complications if TCA leaks into the eye and the injury treatment thereafter are too sparse. The authors therefore report the treatment procedure and follow-up evaluation for a patient who sustained a chemical injury to the eye during rhytidectomy combined with TCA peeling. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .