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Hernio-abdominoplasty with or without Scarpa's Fascia Preservation for Ventral Hernia and Abdominal Wall Deformity.

ABSTRACT: Scarpa's fascia preservation plays a great role in decreasing the volume of wound drainage and reducing seroma after abdominoplasty. This study aimed to assess the role of Scarpa's fascia preservation in patients with ventral hernias associated with abdominal wall deformity who underwent concomitant hernio-abdominoplasty in terms of early and late postoperative outcome and quality of life. Methods:Patients with ventral hernia and abdominal wall deformity underwent combined hernio-abdominoplasty. Patients were randomly allocated to 1 of 2 equal groups: group I underwent Scarpa's fascia preserving hernio-abdominoplasty and group II underwent hernio-abdominoplasty with removal of Scarpa's fascia. Volume of drainage, time to remove drains, return to work, and complications were recorded. Results:Fifty patients (49 female) were included to the study. Both groups had comparable operation time, pain score, and complication rate (24% versus 40%, P = 0.36). The mean total volume of postoperative drainage was significantly lower in group I than group II (686?±?183.5 versus 1410.8?±?371.6?ml; P < 0.0001). Group I had earlier drain removal (11.6?±?1.9 versus 20.5?±?4.2 days, P < 0.0001) and earlier return to work (16.4?±?2.3 versus 23.3?±?3.8 days, P < 0.0001) than group II. There were no recorded cases of hematoma or hernia recurrence after repair. Conclusion:Scarpa's fascia preservation in combined ventral hernia repair and abdominoplasty was associated with significantly lower volume of postoperative drainage, earlier removal of drains, and similar recurrence rate to hernio-abdominoplasty with removal of Scarpa's fascia.

SUBMITTER: Eltantawy M

PROVIDER: S-EPMC6952146 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Hernio-abdominoplasty with or without Scarpa's Fascia Preservation for Ventral Hernia and Abdominal Wall Deformity.

Eltantawy Mahmoud M Elshobaky Ayman A Thabet Waleed W Emile Sameh S El-Said Mohammed M Elshobaky Mohamed Taher MT Mahmoud Sabry Ahmed SA

Plastic and reconstructive surgery. Global open 20190705 7

Scarpa's fascia preservation plays a great role in decreasing the volume of wound drainage and reducing seroma after abdominoplasty. This study aimed to assess the role of Scarpa's fascia preservation in patients with ventral hernias associated with abdominal wall deformity who underwent concomitant hernio-abdominoplasty in terms of early and late postoperative outcome and quality of life.<h4>Methods</h4>Patients with ventral hernia and abdominal wall deformity underwent combined hernio-abdomino ...[more]

PMID: 31942338

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Project description:ObjectiveAbdominal wall hernias are common abdominal diseases, and effective hernia repair is challenging. In clinical practice, synthetic meshes are widely applied for repairing abdominal wall hernias. However, postoperative complications, such as inflammation and adhesion, are prevalent. Although biological meshes can solve this problem to a certain extent, they face the problems of heterogeneity, rapid degradation rate, ordinary mechanical properties, and high-cost. Here, a novel electrospinning mesh composed of polylactic acid and silk fibroin (PLA-SF) for repairing abdominal wall hernias was manufactured with good physical properties, biocompatibility and low production cost.Materials and methodsFTIR and EDS were used to demonstrate that the PLA-SF mesh was successfully synthesized. The physicochemical properties of PLA-SF were detected by swelling experiments and in vitro degradation experiments. The water contact angle reflected the hydrophilicity, and the stress‒strain curve reflected the mechanical properties. A rat abdominal wall hernia model was established to observe degradation, adhesion, and inflammation in vivo. In vitro cell mesh culture experiments were used to detect cytocompatibility and search for affected biochemical pathways.ResultsThe PLA-SF mesh was successfully synthesized and did not swell or degrade over time in vitro. It had a high hydrophilicity and strength. The PLA-SF mesh significantly reduced abdominal inflammation and inhibited adhesion formation in rat models. The in vitro degradation rate of the PLA-SF mesh was slower than that of tissue remodeling. Coculture experiments suggested that the PLA-SF mesh reduced the expression of inflammatory factors secreted by fibroblasts and promoted fibroblast proliferation through the TGF-β1/Smad pathway.ConclusionThe PLA-SF mesh had excellent physicochemical properties and biocompatibility, promoted hernia repair of the rat abdominal wall, and reduced postoperative inflammation and adhesion. It is a promising mesh and has potential for clinical application.

Dataset Information

Hernio-abdominoplasty with or without Scarpa's Fascia Preservation for Ventral Hernia and Abdominal Wall Deformity.

Publications

Hernio-abdominoplasty with or without Scarpa's Fascia Preservation for Ventral Hernia and Abdominal Wall Deformity.

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