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Abdominal skin tensile strength in aesthetic and massive weight loss patients and its role in ventral hernia repair.

ABSTRACT: BACKGROUND:Clarifying the biomechanics of abdominal skin could lead to different uses for this tissue such as the ventral repair of hernias in patients with excess skin and incisional hernias. The objective of this study was to compare the maximum tensile strength of abdominal skin to commercial meshes and to verify whether or not it varies between aesthetic patients and massive weight-loss patients. METHODS:Experimental cross-sectional study. Skin samples sized 32?×?20 mm were taken from 15 abdominoplasties and 10 panniculectomies. The skin specimens were analyzed in vertical and horizontal tensile strength tests. Results were compared between the two groups including their traction directions. Commercial meshes were also tested. The results were analyzed using the Generalized Estimating Equation. RESULTS:The maximum tensile strength supported vertically by abdominal dermis was 403.5?±?27.4?N in the abdominoplasty group and 425.9?±?33.9?N in the panniculectomy group. Horizontally, the values were 596.5?±?32.2?N and 612.5?±?43.9?N respectively. The strengths between traction directions were significantly different (p?

SUBMITTER: Barreiro G

PROVIDER: S-EPMC6595693 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Abdominal skin tensile strength in aesthetic and massive weight loss patients and its role in ventral hernia repair.

Barreiro Guilherme G de Lima Vinícius S VS Cavazzola Leandro T LT

BMC surgery 20190626 1

<h4>Background</h4>Clarifying the biomechanics of abdominal skin could lead to different uses for this tissue such as the ventral repair of hernias in patients with excess skin and incisional hernias. The objective of this study was to compare the maximum tensile strength of abdominal skin to commercial meshes and to verify whether or not it varies between aesthetic patients and massive weight-loss patients.<h4>Methods</h4>Experimental cross-sectional study. Skin samples sized 32 × 20 mm were ta ...[more]

PMID: 31242888

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Project description:BackgroundIn ventral hernia surgery, mesh implants are used to reduce recurrence. Infection after mesh implantation can be a problem and rates around 6-10% have been reported. Bacterial colonization of mesh implants in patients without clinical signs of infection has not been thoroughly investigated. Molecular techniques have proven effective in demonstrating bacterial diversity in various environments and are able to identify bacteria on a gene-specific level.ObjectiveThe purpose of this study was to detect bacterial biofilm in mesh implants, analyze its bacterial diversity, and look for possible resemblance with bacterial biofilm from the periodontal pocket.MethodsThirty patients referred to our hospital for recurrence after former ventral hernia mesh repair, were examined for periodontitis in advance of new surgical hernia repair. Oral examination included periapical radiographs, periodontal probing, and subgingival plaque collection. A piece of mesh (1×1 cm) from the abdominal wall was harvested during the new surgical hernia repair and analyzed for bacteria by PCR and 16S rRNA gene sequencing. From patients with positive PCR mesh samples, subgingival plaque samples were analyzed with the same techniques.ResultsA great variety of taxa were detected in 20 (66.7%) mesh samples, including typical oral commensals and periodontopathogens, enterics, and skin bacteria. Mesh and periodontal bacteria were further analyzed for similarity in 16S rRNA gene sequences. In 17 sequences, the level of resemblance between mesh and subgingival bacterial colonization was 98-100% suggesting, but not proving, a transfer of oral bacteria to the mesh.ConclusionThe results show great bacterial diversity on mesh implants from the anterior abdominal wall including oral commensals and periodontopathogens. Mesh can be reached by bacteria in several ways including hematogenous spread from an oral site. However, other sites such as gut and skin may also serve as sources for the mesh biofilm.

Dataset Information

Abdominal skin tensile strength in aesthetic and massive weight loss patients and its role in ventral hernia repair.

Publications

Abdominal skin tensile strength in aesthetic and massive weight loss patients and its role in ventral hernia repair.

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