The healing of aponeurotic incisions

Douglas, Dan

doi:10.1002/bjs.18004015918

Cited by 119 publications

(50 citation statements)

References 7 publications

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“…The general curves of healing (Fig. 533) are similar to those previously recorded (Douglas, 1952) and are linear when time is recorded on a logarithmic scale (Fig. 534).…”

Section: Resultsmentioning

confidence: 72%

“…This necessitated discarding the data from such animals. The adrenalectomized in a previous paper (Douglas, 1952 animals were given a weekly injection of 7.5 mg. of D.O.C.A. in almond oil.…”

Section: Methodsmentioning

confidence: 99%

“…

…”

mentioning

confidence: 94%

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The effect of endocrine ablation on the healing of incised wounds in aponeurosis

Douglas

1957

British Journal of Surgery

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I N a previous study (Douglas, 1952) it was observed that the healing of incised wounds in the lumbodorsal aponeurosis of rabbits followed a regular pattern in which two features were prominent :-exponential in form and in two independent sets of data was very similar.It was originally intended to have 20 animals in each group, but because of the high mortality of hypophysectomy and of adrenalectomy, we had to be content with 15 and 11 animals in these groups Hypophysectomy was carried out by the parapharyngeal technique of Jacobsohn and Westman I. The curve of gain of tensile strength is respectively. 2. The wound remains weaker than the parent tissue for at least three months and, as a rule, does not regain its original strength even after one year.The constancy of these findings suggested that the process was systemically controlled and attempts have now been made to investigate the role of the endocrine glands. METHODSAdult rabbits were divided into five groups: Groups I, 2, and 3 were submitted to hypophysectomy, bilateral adrenalectomy, and thyroidectomy respectively ; Group 4 was used as a control group ; and Group 5 was submitted to nephrectomy to provide operative trauma comparable to adrenalectomy, but not being associated as far as is known with hormone deprivation.(1940) and proved to be a most lethal operation, a large number of rabbits being submitted to the operation to obtain the 15 survivors. Most of the deaths were due to respiratory obstruction from blood leaking into the posterior nares. Other deaths were due to hypoglycaemia during the first 24 hours, even though the animals were given 20 ml. of 5 per cent dextrose in water subcutaneously after operation. The completeness of the hypophysectomy was checked by post-mortem examination.Adrenalectomy was carried out by a two-stage lumbar approach. Because of the intimate relationship of the right adrenal to the vena cava it was found quite impossible to remove the right adrenal by ordinary dissection. An attempt was made to overcome this by resecting a segment of the vena

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“…The general curves of healing (Fig. 533) are similar to those previously recorded (Douglas, 1952) and are linear when time is recorded on a logarithmic scale (Fig. 534).…”

Section: Resultsmentioning

confidence: 72%

Section: Methodsmentioning

confidence: 99%

“…

…”

mentioning

confidence: 94%

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The effect of endocrine ablation on the healing of incised wounds in aponeurosis

Douglas

1957

British Journal of Surgery

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“…As collagen matures the tensile strength of the wound steadily increases, its vascularity and cellularity diminish, and the final product is the connective, fibrous, or scar tissue of wound repair (Dunphy, 1960). The strength of healing aponeurosis has been studied by Douglas (1952). He has shown that sutured cut edges of divided lumbodorsal aponeurosis in rabbits give a tensile strength of about 20 per cent of normal in 2 or 3 weeks and of only about 50 per cent of normal in 4 to 6 weeks.…”

Section: Repair Herniotomy With Ring Repair-ifmentioning

confidence: 98%

The deep inguinal ring, development, function and repair

Lytle¹

1970

Journal of British Surgery

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The deep inguinal ring opening, due to the outgrowth of the processus vaginalis around the gubernaculum, appears at the end of the 2nd month of foetal life. Around this opening the U-shaped ring of transversalis fascia begins to develop about the 5th month. The U-shaped ring is well formed and its valvular design established at the 7th month. Descent of the testis usually takes place during the 7th or 8th month of intra-uterine life, but the processus vaginalis, which should normally close before or soon after birth, may remain open throughout life. The pressure valve of the deep inguinal ring, with its active closure mechanism, is capable of protecting an open processus vaginalis, often for months or years, against the onset of a hernia. The need to join together cut or raw edges to give sound union is emphasized and the indications for ring repair in oblique hernia and major repair in direct hernia are outlined.

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“…Laxity may also be caused by congenital connective tissue weakness. [10,11]. The aim of this study was to apply generic guidelines to reconstructive vaginal operations, so as to convert them to ambulatory procedures.…”

Section: P E Papa Petrosmentioning

confidence: 99%

Development of generic models for ambulatory vaginal surgery — a preliminary report

Petros

1998

Int Urogynecol J

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Generic guidelines are applied to reconstructive vaginal operations, so as to convert them to ambulatory procedures. Prototype operations are described and analyzed. These included conceptualizing vaginal prolapse as a type of intussusception caused by vaginal and ligamentous laxity in the middle or posterior parts of the vagina; the avoidance of vaginal excision, excessive tension, and refashioning excess vaginal tissue from width to length or into a partial double-layered repair; the creation of artificial neoligaments; the prevention of urinary retention by avoiding tightness in the bladder neck area; local anesthetic infiltration; and buttressing vaginal tissue during wound healing. A total of 108 patients underwent vaginal surgery on an ambulatory or overnight stay basis, 72 under local anesthesia/midazolam. Minimal postoperative pain and the absence of catheterization reduced hospital stay from a statewide mean of 8 days to 1 day, and return to normal activities from 6 weeks to 7-10 days. Cure rates (18 months) were: uterovaginal prolapse 22/22, infracoccygeal sacropexy 21/23, rectocele 36/38, cystocele/anterior vaginal wall prolapse 21/25. Applied as prototypes to reconstructive vaginal surgery, the operations appear to be as effective as traditional techniques but far less invasive. They have the potential to assist working mothers, the old and infirm, and save the community up to $5,500 per patient. It is hoped that the generic models presented may act as a basis for the future development of ambulatory vaginal surgical techniques.

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The healing of aponeurotic incisions

Cited by 119 publications

References 7 publications

The effect of endocrine ablation on the healing of incised wounds in aponeurosis

The effect of endocrine ablation on the healing of incised wounds in aponeurosis

The deep inguinal ring, development, function and repair

Development of generic models for ambulatory vaginal surgery — a preliminary report

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