Abdominoplasty: The Use of Stapled Prolene Mesh in Severe Musculoaponeurotic Laxity

Kaddoura, Imad L.; Nasser, Ali

doi:10.1016/s1090-820x(98)70088-3

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…Moreover, only 13.16% (5/38) of our patients who underwent mesh-abdominoplasty required refashioning surgery. In agreement with our findings, Kaddoura and Nasser [26], who used a stapled Prolene mesh for reinforcement of midline abdominal wall plication in 21 multiparous patients with severe musculo-aponeurotic laxity reported that 4 patients (19%) underwent umbilical and dog ear revisions.…”

Section: Global Journal Of Surgerysupporting

confidence: 92%

“…Despite severe musculo-aponeurotic laxity in our multiparous patients, extensive abdominal contouring technique, addition of liposuction and the application of a Prolene mesh to reinforce the midline plication in Group 2 patients, no major complications were encountered. Moreover, the occurrence of wound complications reported herein was comparable in both groups, which correlates with the results reported in the literature [23,24,25] including multiparous women [13], the use of stapled Prolene mesh [26], or the application of a submuscular resorbable mesh [27]. The use of Prolene mesh in the present study did not add to the occurrence of post-operative seroma, which was recorded in 6.41% of patients, which coincides with the 3%-7% reported post-abdominoplasty by several authors [7,28].…”

Section: Global Journal Of Surgerysupporting

confidence: 90%

“…In this particular group of patients, the use of Marlex mesh for plication of abdominoplasty in a study by Marques et al [38] provided a marked degree of musculo-aponeurotic reinforcement without any infection, dehiscence, or extrusion of the mesh in any of the 18 patients reviewed. Similarly, a suture midline plication followed by fixation of a Prolene mesh with 2/0 Prolene sutures provided a safe and reliable technique with no associated reports of major complications [26], which is consistent with the results presented in this study utilizing a similar technique.…”

Section: Global Journal Of Surgerysupporting

confidence: 88%

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Outcome of Combining Ventral Hernia Repair with Abdominoplasty or Mesh-abdominoplasty in Multiparous Women

Sakr¹,

Habib²,

Hamed³

et al. 2019

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Objectives: to determine the outcome of ventral hernia repair during abdominoplasty and mesh-abdominoplasty regarding cosmesis, recurrence and post-operative complications. Subjects and Methods: The present retrospective study included 78 multiparous women with ventral hernia and abdominal wall deformity. Age ranged between 28 and 59 years with a mean of 41.37±11.18 years. Half of the patients suffered from episodes of colicky abdominal pain and 34 (43.6%) had chronic low back pain. Forty patients (with defect < 3cm) underwent standard abdominoplasty (Group 1) and 38 (with defect > 3cm) underwent mesh-abdominoplasty (Group 2), both after primary suture hernia repair and midline fascial plication. The follow-up period ranged from 22 months to 11 years with a mean of 62.5 months. Results: Both groups were comparable regarding their demographic and clinical parameters. Patients with abdominoplasty had significantly (p=0.0193) more para-umbilical hernias (PUHs) than those with mesh-abdominoplasty (80% vs 55.3%, respectively), but had less incisional or recurrent PUHs. All repaired hernias did not recur except for one patient in each group. No mortality or major complications were encountered. Wound complications occurred in 7 patients (17.5%) in Group 1 vs 10 (26.3%) in Group 2 (p=0.346). Recurrence of abdominal wall deformity and the need for a second refashioning procedure were significantly higher among patients who underwent abdominoplasty alone (p=0.011 and p=0.0139, respectively). Conclusions: (1) During abdominoplasty, ventral hernia repair and midline plication can be performed in defects <3 cm with no increase in hernia recurrence rate, (2) in patients with defects >3 cm, additional mesh reinforcement is indicated and (3) Prolene mesh-abdominoplasty for multiparous women with severe musculo-aponeurotic laxity and ventral hernia, yields lower recurrence of abdominal deformity and less refashioning procedures with minimal complications than abdominoplasty alone.

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Section: Global Journal Of Surgerysupporting

confidence: 92%

Section: Global Journal Of Surgerysupporting

confidence: 90%

Section: Global Journal Of Surgerysupporting

confidence: 88%

See 1 more Smart Citation

Outcome of Combining Ventral Hernia Repair with Abdominoplasty or Mesh-abdominoplasty in Multiparous Women

Sakr¹,

Habib²,

Hamed³

et al. 2019

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“…Of the 56 included studies, 31 described open RD repairs (multiple studies described several approaches amounting to a total of 39 technical variations described) [12–42] while 28 studies described laparoscopic RD repairs [19, 38, 42–67]. Three studies described both open and laparoscopic repairs [19, 38, 42].…”

Section: Resultsmentioning

confidence: 99%

Open Versus Laparoscopic Surgical Management of Rectus Diastasis: Systematic Review and Pooled Analysis of Complications and Recurrence Rates

et al. 2022

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Background Rectus diastasis (RD) is defined as widening of the linea alba and laxity of the abdominal muscles. It can be treated via a wide array of both conservative and surgical modalities. Due to the quickly evolving nature of this field coupled with the multiple novel surgical modalities described recently, there is a need for an updated review of surgical techniques and a quantitative analysis of complications and recurrence rates. Methods A systematic review of PUBMED and EMBASE databases was preformed to retrieve all clinical studies describing surgical management of RD. Pooled analyses were preformed to assess recurrence and complication rates after both open and laparoscopic RD repairs (after controlling for herniorrhaphy). Results A total of 56 papers were included in this review. In patients who underwent both an RD and a herniorrhaphy, there was no significant difference in recurrence rates between open (0.86%) and laparoscopic repairs (1.6%) (p > 0.05). Similarly, in patients who underwent RD repair without a herniorrhaphy, there was no significant difference in recurrence rates between open (0.89%) and laparoscopic repairs (0%) (p > 0.05). The most common complications reported were seroma, skin dehiscence, hematoma/post‐operative bleeding, and infection. After controlling for a herniorrhaphy, there were no significant difference in total complication rates between open and laparoscopic RD repair. The total complication rates in patients who underwent an open RD repair with a herniorrhaphy were 13.3% compared to 14.5% in patients who underwent laparoscopic repairs (p > 0.05). Similarly, the total complication rates in patients who underwent RD repair without a herniorrhaphy were 11.8% in patients who underwent open repairs compared to 16.2% in their counterparts who underwent laparoscopic repairs (p > 0.05). Conclusion Both open and laparoscopic approaches are safe and effective in repairing RD in patients with and without concurrent herniorrhaphy. Future research should report patient reported outcomes to better differentiate between different surgical approaches.

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“…The second study documenting the use of mesh during abdominoplasty was published by Kaddoura et al in 1998. 5 This study, conducted from October 1995 to November 1997, included 21 female patients aged 31 to 59 years (mean age, 38 years). These patients were reported to have had Prolene mesh placed with an average size of 20-× 30-cm, where suture was used in all except the last 8 cases, which had the mesh secured using a stapled technique.…”

Section: Literature Reviewmentioning

confidence: 99%

The Use of Mesh Reinforcement during Abdominoplasty: A Case Report and Literature Review

Tavassoli¹,

Haiavy²

2011

Am J Cosmet Surg

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Introduction: Abdominoplasty is a well-established procedure that consistently ranks in the top 5 most common cosmetic surgical procedures performed in the United States per year. In cases of severe myoaponeurotic laxity some surgeons choose to supplement their procedure with the placement of mesh to reinforce their plication. Some surgeons place mesh on a more routine basis. There is limited data in the literature to substantiate the use of synthetic mesh. This is a case report and review of the literature for the use of mesh reinforcement during abdominoplasty. Materials and Methods: A case report is presented, detailing the infectious complications suffered by 1 patient subsequent to abdominoplasty with mesh reinforcement. A thorough review of the literature was performed. Literature was evaluated with respect to the number of patients, age range, type of mesh, method of fixation, follow-up interval, complications, and cosmetic results. Results: Four studies were found assessing the use of mesh reinforcement during abdominoplasty. Number of patients was limited, ranging from 18 to 52. Types of mesh included Polypropylene, Prolene, and Vicryl. No infection, dehiscence, or extrusion of mesh were reported. Authors report stable repair with follow-up ranging from 6 months to 54 months in cases involving severe myoaponeurotic laxity only. Conclusions: Following review of the literature, it is clear that the evidence to support routine placement of mesh during abdominoplasty is lacking. As demonstrated by the case report described, placement of mesh in any procedure puts the patient at risk for undue sequelae. Our recommendations are as follows: Do not use mesh reinforcement during routine abdominoplasty. In only the worst cases of myoaponeurotic laxity, consider placing mesh using an onlay technique or in a submuscular layer (if experienced with this procedure), recognizing the limitations of the current literature on this subject. In either case, the surgeon should be aware of the significant risks of complications involved with these procedures, including seroma, umbilical and flap necrosis, as well as infection. If mesh is placed at the time of surgery, make certain that the patient is aware of the fact. In cases of wound infection where mesh was placed, have a high suspicion for mesh infection and a low threshold for reoperation.

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Abdominoplasty: The Use of Stapled Prolene Mesh in Severe Musculoaponeurotic Laxity

Cited by 10 publications

References 14 publications

Outcome of Combining Ventral Hernia Repair with Abdominoplasty or Mesh-abdominoplasty in Multiparous Women

Outcome of Combining Ventral Hernia Repair with Abdominoplasty or Mesh-abdominoplasty in Multiparous Women

Open Versus Laparoscopic Surgical Management of Rectus Diastasis: Systematic Review and Pooled Analysis of Complications and Recurrence Rates

The Use of Mesh Reinforcement during Abdominoplasty: A Case Report and Literature Review

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