Incisional hernia

Yelimlies B, Alponat A, Cubukcu A, et al. Carboxymethylcellulose coated on visceral face of polypropylene mesh prevents adhesion without impairing wound healing in incisional hernia model in rats. Hernia 2003 7(3) 130-133. 

Van t Riet M, de Vos Van Steenwijk PJ, Bonthuis F, Marquet RE, Steyer-berg EW, Jeekel J, Bonjer HJ. Prevention of adhesion to prosthetic mesh comparison of different barriers using an incisional hernia model. Ann Surg 2003 237 123-128. 

Expanded poly(tetrafluoro ethylene) (ePTFE) CORE-TEX W.L. Core Associates, Flagstaff, USA Regenerative membrane, osteoconductive membrane, large diameter aortic, and carotid vascular grafts, tension-free repair of ventral incisional hernia orbital reconstruction, facial reconstruction, rhinoplasty... 

Poly(propylene) is one of the biocompatible, biostable polymer used widely in clinical applications ranging from sutures to load-bearing implants (Figure 18.1b). Poly(propylene) has fiber-forming characteristics and has been used in the treatment of ventral incisional hernia [22,23]. Poly(propylene) has excellent stiffness and strength when compared to polyethylene [24]. Superior mechanical performance in fatigue and temperature resistance offers sufficient mechanical property even at body temperature and able to bear millions... 

J.R. San Pio, T.E. Damsgaard, O. Momsen, 1. Villadsen, J. Larsen, Repair of giant incisional hernias with polypropylene mesh a retrospective study, Scand. J. Blast. Reconstr. Surg. Hand Surg. 37 (2) (2003) 102-106. 

A 65-year-old lady was admitted to hospital for repair of a strangulated incisional hernia. Post-operatively the wound site failed to heal. The patient was sent home with a discharging and offensive wound. She returned three days later with a gaping and infected wound, which required cleansing and re-suturingimder a general anaesthetic, antibiotics and an extended hospital stay of 15 days. 

Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term foUow-np of a randomized controlled trial of sntnre versus mesh repair of incisional hernia. Arm Surg 2004 240 578-83. 

Cassar K, Mnnro A. Surgical treatment of incisional hernia. BrJ Surg 2002 89 534-45. 

Basoglu M, YUdirgan MI, YUmaz I, Bahk A, Celebi F, Atamanalp SS, et al. Late complications of incisional hernias following prosthetic mesh repair. Acf ChirBelg 2004 104 425-8. 

Vorst AL, Kaotzanis C, Carbonell AM, Franz MG. Evolution and advances in laparoscopic ventral and incisional hernia repair. World J Gastrointest Surg 2015 7(ll) 293-305. 

Gurrado A, Franco IF, Lissidini G, Greco G, De Fazio M, Pasculli A, et al. Impact of pericardium bovine patch (Tutomesh) on incisional hernia treatment in contaminated or potentially contaminated fields retrospective comparative study. Hernia 2015 19(2) 259-66. 

Deeken CR, Mehnan L, Jenkins ED, Greco SC, FriseUa MM, Matthews BD. Histologic and biomechanical evaluation of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral incisional hernia repair. JAm Coll Surg 2011 212(5) 880-8. 

Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Nannestad Joigenen LN. Smoking is a risk factor for incisional hernia. Arch Surg 2005 140(2) 119-23. 

Fischer T, Ladumer R, Gangkofer A, Mussack T, Reiser M, Lienemann A. Functional cine MRl of the abdomen for the assessment of implanted synthetic mesh in patients after incisional hernia repair initial results. Eur Radiol 2007 17 3123-9. 

Polyethylene, In tubing, syringes, oxygen tents, repair of incisional hernias, stomach wall support, repair of tissue damage, heart valves, contraceptive implants. 

Sutures are foreign bodies, and althongh modem synthetic monofilament sutures are almost completely inert, braided and natural sutures can excite a significant inflammatory response. Bacteria can be difficnlt or impossible to eradicate once colonization of the suture or knot interstices has occurred. This can predispose the wound site to infection, with abscess and sinus formation, wound dehiscence, and incisional hernias. Sutures should be avoided or used with caution in the presence of established infection or severe contamination. 

Breakdown of suture lines and leakage are a common complication of the early postoperative phase. Afferent loop syndrome is a specific problem of Billroth II procedures and is caused by mechanical obstruction usually from adhesions. Internal hernias, extrinsic compression, bowel stenosis may also occur. Bezoar formation in the gastric remnant, anastomotic ulcers, incisional hernia of the abdominal wall and hiatal hernia are all also potential complications. Stenosis of the gastrojejunostomy after Billroth II procedures leads to obstruction (Fig. 13.14). Fistula after Billroth II is rare (Fig. 13.15). Tumour of the gastric renmant can be due to recurrence or present as a primary carcinoma of the stump (Fig. 13.16). 

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