Reconstruction of Complex Abdominal Wall Defects

Bath, AS; Patnaik, PK; Bhandari, PS

doi:10.1016/s0377-1237(07)80053-0

Cited by 7 publications

(2 citation statements)

References 14 publications

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“…It provides a scaffold for the deposition of host connective tissue and epithelial tissue, and is almost entirely replaced by wellorganised host tissue after 4 weeks. 1 It has been used successfully, as an onlay or an inlay graft, to provide tension-free repair for large abdominal hernias in contaminated fields, where the more widely used polypropylene mesh has failed. Also, its use for the repair of abdominal hernias in immunocompromised patients has proven to be effective.…”

Section: Discussionmentioning

confidence: 99%

Management of a large abdominal wall defect using Surgisis and partial omentoplasty following blast injury in Afghanistan

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Management of a large abdominal wall defect using Surgisis and partial omentoplasty following blast injury in Afghanistan

et al. 2010

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“…3 In cases where tissue loss will lead to inadequate coverage of the repair, plastic surgical input may be required for splitskin graft or flap reconstruction. 58 In cases with unstable skin coverage, flap closure appears superior to mesh alone. 59 This will require interdisciplinary work with the plastic surgery team.…”

Section: Techniques To Allow Fascia Closurementioning

confidence: 99%

An Evaluation of the Evidence Guiding Adult Midline Ventral Hernia Repair

Sagar

Tapuria

2022

Surg J (N Y)

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Purpose: Several guidelines have been published in recent years to guide the clinician in ventral hernia repair. This review distils this advice, critically assesses their evidence base, and proposes avenues for future study. Methods: A PUBMED search identified four guidelines addressing midline ventral hernia repair published by major surgical societies between 2016 and 2020. The studies used to inform the advice have been critically appraised, including 20 systematic reviews/meta-analyses, 10 randomized controlled trials, 32 cohort studies, and 14 case series. Results: Despite a lack of randomized controlled trials, case heterogeneity, and variation in outcome reporting, key themes have emerged.Preoperative computed tomography scan assesses defect size, loss of domain, and the likely need for component separation. Prehabilitation, frailty assessment, and risk stratification are beneficial in complex cases. Minimally invasive component separation techniques, Botox injection, and progressive pneumoperitoneum represent novel techniques to promote closure of large fascial defects.Rives-Stoppa sublay mesh repair has become the “gold” standard for open and minimally invasive repairs. Laparoscopic repair promotes early return to functional status. The enhanced-view totally extraperitoneal approach facilitates laparoscopic sublay mesh placement, avoiding mesh contact with viscera. Robotic techniques continue to evolve, although the evidence at present remains immature.Synthetic mesh is recommended for use in clean and clean-contaminated cases. However, optimism regarding the use of biologic and biosynthetic meshes in the contaminated setting has waned. Conclusions: Surgical techniques in ventral hernia repair have advanced in recent years. High-quality data has struggled to keep pace; rigorous clinical trials are required to support the surgical innovation.

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