UP-1.143: Incisional Hernia of Surgical Site After Kidney Transplantation and its Repair with Propylene Mesh

Zafarghandi, R. Mahdavi; Mehrabi, M; Ghaior, A.; Zafarghandi, M. Mahdavi

doi:10.1016/j.urology.2009.07.590

Cited by 3 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this position exposes the patient to the risk of small bowel occlusion and enterocutaneous fistula [23]. Five retrospective studies of IH after renal transplantation [14,15,[17][18][19] reported the mesh position. The onlay mesh position was used in all but three of the patients in whom the underlay position was used because of the size of the fascial defect [14].…”

Section: Discussionmentioning

confidence: 99%

“…However, it is also assumed that transplant patients are more susceptible to incisional and mesh infections after hernia repair because of immunosuppression. Several retrospective studies [14][15][16][17][18][19] have determined the predictive factors for incidence of IH, its recurrence, and postoperative complications after surgical repair of IH following renal transplantation. No studies have compared the postoperative outcomes following LIH mesh repair between patients who have previously undergone renal transplantation and those who have not.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lateral Incisional Hernia After Renal Transplantation: A Comparative Study

et al. 2014

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lateral Incisional Hernia After Renal Transplantation: A Comparative Study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Background and rationale {6a} Background Incisional hernia is a common complication after kidney transplantation with an incidence of 1.6-18.0% [1][2][3][4]. Several studies have identi ed multiple risk factors for the development of post-transplant incisional hernia that can be grouped into patient and donor factors, factors related to immunosuppression and factors related to the location and type of surgical incision [1][2][3][4][5][6][7]. In 2018 Simson et al publish a systematic review of the existing literature that highlights the limited scienti c evidence that is mainly constituted by the review of case series.…”

Section: Introductionmentioning

confidence: 99%

“…Although the incidence of incisional hernia in lateral laparotomies is lower than that of median laparotomy, their treatment is considered to be more complex, especially in the context of kidney transplantation in relation to surgical incision lateral position to the sheath of the rectus abdominis muscle, graft presence in the iliac fossa, di cult xation for prostheses because of the proximity to the inguinal area, costal margin and iliac bones and immunosupresion [3], [5][6][7], [12][13][14][15]. In the present study we used the de nition of eventration or incisional hernia accepted by the European Hernia Society: "Eventration or incisional hernia is any defect in the abdominal wall with or without associated bulging in the area of a surgical scar perceptible or palpable by physical examination or imaging tests" [16].…”

Section: Introductionmentioning

confidence: 99%

Prevention of Incisional Hernia after Kidney Transplantation: Study Protocol for a Randomized Controlled Trial

Gómez-Dos-Santos

Plaza

Villar

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Incisional hernia is a common complication after kidney transplantation with an incidence of 1.6-18%. Concerning non-transplant patients, a recently published meta-analysis describes a reduction of the incidence of incisional hernia of up to 85% due to prophylactic mesh replacement in elective, midline laparotomy. The aim of our study is to show a reduction of the incidence of incisional hernia after kidney transplantation with minimal risk for complication. Methods/design: This is a blinded, randomized controlled trial comparing time to incisional hernia over a period of 24 months between patients undergoing kidney transplantation and standardized abdominal closure with or without prophylactic placement of ProGrip™ (Medtronic. Fridley, Minnesota. USA) mesh in an onlay position. As we believe that the mesh intervention is superior to the standard procedure in reducing the incidence of hernia, this is a superiority trial. Discussion: The high risk for developing incisional hernia following kidney transplantation might be reduced by prophylactic mesh placement. ProGrip™ mesh features polylactic acid (PLA) microgrips that provides immediate, strong and uniform fixation. The use of this mesh combines the effectiveness demonstrated by the macropore propylene meshes in the treatment of incisional hernias, a high simplicity of use provided by its capacity for self-fixation that doesn´t increase significantly surgery time, and safety. Trial registration: ClinicalTrials.gov. ID: NCT04794582. Registered on 08 March 2021. Protocol version 2.0. (02-18-2021)

show abstract

“…The incidence rate of abdominal wound complications in transplant recipients is 7.7-21%,3,5-13, with superficial wound dehiscence being the most common. [3,5]. Soft tissue must be given particular care during abdominal wall reconstruction to minimize wound healing issues that might lead to mesh infection and hernia recurrence [6].…”

Section: Introductionmentioning

confidence: 99%

Abdominal Flap Reconstruction Over Necrotic Skin Post Renal Transplantation: A Case Report

2023

Plast Surg Mod Tech

View full text Add to dashboard Cite

Background: Although wound complications post renal transplantation procedure is not strange, presenting with loss of skin at the right lower quadrant and an exposed recipient kidney is definitely extremely extraordinary. The purpose of this case study is to showcase a patient who developed substantial necrosis of the skin of the abdominal wall following a Living unrelated Right Renal transplantation (LURRT) procedure in order to highlight the importance of protecting rectus abdominis perforator blood vessels in order to maintain skin vitality. Case Report: 67-year-old female presented with skin necrosis and exposed transplanted kidney. The patient has a history of End Stage Renal Disease, Crohn's disease, and secondary adrenal insufficiency. The patient underwent ileocecal resection and ileostomy creation. The patient underwent Living unrelated Right Renal transplantation (LURRT) with a complicated post-transplant course. The wound edges were refreshed and the wound base was curetted and irrigated with antibiotics. A mesh of Acellular Dermal Matrix (ADM) was placed over the exposed kindly covering it completely and two abdominal local flaps were advanced to close the defect. Conclusion: Kidney transplantation is the preferred treatment for end-stage renal disease over dialysis. Surgical site complications (SSCs) are a major cause of morbidity in kidney transplant recipients, so when making an abdominal incision, always consider the blood supply provided to surrounding structures, and keep the risk of compromising abdominal perforator blood vessels in mind. Thus, proper anatomical planning prior to surgery can aid in avoiding such a catastrophic outcome.

show abstract

UP-1.143: Incisional Hernia of Surgical Site After Kidney Transplantation and its Repair with Propylene Mesh

Cited by 3 publications

References 0 publications

Lateral Incisional Hernia After Renal Transplantation: A Comparative Study

Lateral Incisional Hernia After Renal Transplantation: A Comparative Study

Prevention of Incisional Hernia after Kidney Transplantation: Study Protocol for a Randomized Controlled Trial

Abdominal Flap Reconstruction Over Necrotic Skin Post Renal Transplantation: A Case Report

Contact Info

Product

Resources

About