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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 102 abdominal surgical wounds in cancer patients were closed with absorbable suture material. The object of the study was to evaluate whether patients with cancer having possible wound healing impairments could be closed with absorbable sutures, thereby omitting the difficulties involved with retention sutures or nonabsorbable material. Polyglycolic acid sutures were used in the fascia in all of these patients, and they were studied regarding the incidence of wound infection, wound dehiscence, and incisional hernias. There were no instances of wound dehiscence in the entire series. A wound infection rate of 14.8% was encountered. The incidence of incisional hernia following either infection or primary healing was noted to be markedly decreased. The rate of wound dehiscence and wound hernia was sufficiently low to lead us to recommend this type of abdominal wound closure in all cancer patients.
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PMID:The closure of abdominal wounds in cancer patients. 13 51

A series of 814 consectuvie laparotomy incisions at three hospitals were closed with No 2 Dexon (polyglycolic acid) sutures using the 'near and far' technique. The incidence of wound dehiscence was 0.5%, of sinus formation 1%, and of incisional hernia 2.2% at 6 months and 6% at 3 years.
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PMID:Wound closure with Dexon (polyglycolic acid) mass suture. 34 27

The study is a comparison of Dexon (polyglycolic acid) and Mersilene (polyester) sutures when employed for the primary closure of the peritoneum and aponeurotic layer in primary laparotomy incisions. The material comprises 308 closures of abdominal wounds with interrupted 2-0 sutures (United States Pharmacopeia) in the aponeurosis and continuous 2-0 suture of the peritoneum. One half of the wound was closed with Dexon and the other half with Mersilene, so that the patient acted as his own control. No significant difference was found between the two materials as evaluated from the occurrence of wound rupture within 10 days and incisional hernia within 90 days of the operation. Suture granulomas occurred in 9% of the half wounds sutured with Mersilene. The present clinical investigation demonstrates that Dexon sutures are as reliable as unabsorbable material. Dexon is superior to unabsorbable material as suture granulomas were not seen when Dexon was employed.
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PMID:Comparison of Dexon and Mersilene sutures in the closure of primary laparotomy incisions. 78 15

A total of 206 patients were subjected to operation for acute appendicitis through a pararectal laparotomy. Mersilene was used in 101 and polyglycolic acid (PGA, Dexon) in 105 patients as buried sutures for the closure of the abdominal wall, including the fascial layer. Wound complications developed after Mersilene in 23 and after PGA in 10 cases. PGA did not lead to an increased frequency of early wound infections. Granulomata or fistulae developed after Mersilene in 18 patients, but not in any of the cases in which PGA was used. Wound rupture and incisional hernia did not occur in any of the patients in the two groups.
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PMID:A comparison of Mersilene and polyglycolic acid sutures in pararectal abdominal wounds after appendectomy. 103 60

This prospective, randomized study compares continuous absorbable suture (Dexon), continuous nonabsorbable suture (Surgilon) and interrupted absorbable suture (Dexon) for fascial closure of clean and clean-contaminated laparotomy wounds. Three months postoperatively, the overall frequencies were for wound dehiscence 0% (0/238), wound infection 5.5% (13/238), hernia formation 0.4% (1/238) and sinus formation 0% (0/238). After a median period of 41 months (range 14-59 months) a physical examination was performed in 93.7% (224/238) of the patients and the observed overall frequency of hernia was 3.1% (7/224). No difference was detected in incidence of wound complications when comparing the three groups. We conclude that layered closure of a laparotomy wound is safe whether using nonabsorbable or absorbable sutures and whether applying a continuous or interrupted technique in the fascial closure of clean and clean-contaminated wounds.
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PMID:Closure of the abdominal fascia after clean and clean-contaminated laparotomy. 253 63

A rare case of Richter's hernia after laparoscopy, the 2nd such hernia reported among a total of 4 cases of small bowel hernia, is presented. This patient was a 32-year old woman who had Hulka clip sterilization without any difficulties, using a 10 mm trocar and a Wolff laparoscope, with 3 liter carbon dioxide for induction of pneumoperitoneum. Her symptoms were only severe pain and vomiting starting on the 5th postoperative day, and a hematoma-like swelling. Since her pain was so intense, the area was explored under general anesthesia the same day. A plum-sized, strangulated loop of the jejunum was apparent, with serous fluid but no blood, incarcerated between the skin and the abdominal muscles. A small serosal laceration in the bowel was corrected with 2 interrupted Dexon sutures. Symptoms of hernia have occurred 3-15 days after laparoscopy in previously reported cases. It is fortunate that this patient was not treated as though she had a hematoma, since serious perforation of the bowel and peritonitis would have resulted. It is important to insure that all gas has flowed out of the abdomen before removing the laparoscope or the trocar sheath, and advisable to shake the abdomen wall carefully while removing the instruments, to prevent this complication.
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PMID:Incarcerated Richter's hernia after laparoscopy: a case report. 296 30

When polypropylene mesh (Marlex) is used to repair contaminated abdominal-wall hernias, a high incidence of mesh-related chronic infection, drainage, erosion, and bleeding is noted. As an alternative to placing polypropylene mesh in a contaminated field, in the past 18 months we have used an absorbable polyglycolic acid mesh (Dexon) to repair contaminated abdominal-wall defects in eight patients--three with necrotizing abdominal-wall infections, one with an extensive electrical burn of the abdominal wall, three with infected polypropylene mesh from a previous repair, and one whose hernia was covered by a chronically infected scar. In seven of the eight cases, a single sheet of polyglycolic acid mesh was sewn to the fascial margins. In four cases, skin was closed over the mesh; wound packing and subsequent skin grafting were required in the other four. In follow-up studies that ranged from three to 18 months, six of the eight patients developed abdominal-wall hernias at the site of absorbable mesh placement. None of the patients required an abdominal binder. Postoperative hernia development is probable in patients whose defects are repaired with absorbable mesh. However, this complication is balanced against the more serious complications of fistula, bleeding, skin erosion, drainage, and chronic infection, which require removal of the more rigid nonabsorbable meshes in 50% to 90% of cases when the latter are placed under contaminated conditions. Placement of absorbable mesh for temporary abdominal-wall support until wound contamination resolves enhances the likelihood of subsequent successful placement of a permanent mesh.
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PMID:Use of an absorbable mesh to repair contaminated abdominal-wall defects. 301 71

In a prospective, randomized study of 520 inguinal hernioplasties, the incidence of early and late complications was compared after suture with Mersilene or Dexon. The respective overall recurrence rates were 5.1 and 4.9%. Persistent neuralgia was more common in the Mersilene group, necessitating late resection of the ilioinguinal nerve in two patients. Suture fistula occurred after one Mersilene repair. The study indicates that Dexon (absorbable polyglycolic acid) suture is reliable for preventing recurrent hernia. No serious complications were associated with its use.
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PMID:Polyglycolic acid (Dexon) versus Mersilene in repair of inguinal hernia. 609 82

The incidence of wound infection, burst abdomen and incisional herniation after a vertical abdominal incision was studied in a prospective trial comparing polypropylene (Prolene) with polyglycolic acid (Dexon). Wounds were closed by interrupted mass suture with an optional reinforcing continuous closure of the anterior rectus sheath. A total of 347 patients was studied, randomly allocated to suture with either Prolene or Dexon. The two groups were well matched for known risk factors. Dehiscence occurred in 0.6 per cent of patients overall and at 6 months 5.7 per cent of cases had an incisional hernia, although many of these were asymptomatic. There was no difference in the rate of infection, disruption or herniation between the two suture materials.
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PMID:Abdominal wound closure: a trial of Prolene and Dexon. 625 39

In a randomized, double-blind study, comparison was made between absorbable polyglycolic acid sutures (Dexon) and non-absorbable sutures (Dacron) in inguinal and femoral herniorrhaphies. The study comprised 58 patients with 61 hernias. Bassini repair was done in inguinal hernia and McVay repair in femoral hernia. The patients were evaluated at a follow-up examination six months after the operation. There was no wound dehiscence or infection during the primary admission. In one patient from each group there was recurrence of hernia during the observation period. No suture granuloma had developed in that time. These results warrant the use of absorbable sutures in inguinal and in femoral herniorrhaphy.
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PMID:Absorbable suture in hernia repair. 632 89


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