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

Between 4/90 and 2/91 we repaired 105 inguinal hernias according to Shouldice's technique. Instead of an absorbable suture (PDS no.0) we used a PTFE suture no.0. By this study we tried to assure that it is allowed to use as well the non resorbable PTFE suture no.0. in hernia repair as the slowly resorbable PDS suture no.0. We compared the rate of postoperative hematomas, seromas and pus collections and the rate of early recurrences in both groups. The results of the PTFE group were compared with those of a prospective study (n = 100) between 6.88 and 4.89 when we used PDS suture no 0. In the PTFE group we saw 9.5% hematomas, 1.9% seromas and 0.9% pus collections. In the PDS group 4% of the patients developed a hematoma, 4% a seroma and 2% a pus collection. We saw 1.9% early recurrences after 8 months (PTFE: 7-11; median: 9 months) and 3.2% after 9 months (PDS: 8-13; median: 10 months) medium follow-up time. The results did not significantly differ between both groups. (Chi-square test: p = 1.0). By these results we can draw the following conclusions: 1. The use of a non absorbable PTFE suture no 0 in hernia repair is of no disadvantage. 2. The principle of hernia repair is the induction of scar tissue in the site of hernioplasty; the use of slowly resorbable suture material is allowed as well.
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PMID:[Shouldice hernia report with a PTFE suture]. 144 79

In a prospective randomized trial we analyzed the perioperative management, complications, and the recurrence rate of inguinal hernia repair using either resorbable (polydioxanone, PDS) or non-absorbable (polyamide, Ethilon) suture material. From January 1988 to June 1989, 484 consecutive transversalis fascia repairs were performed in 425 adult patients with inguinal or femoral hernia. Local anaesthesia was used in 273 cases. At least one year postoperatively, 390 patients with 445 repairs had a clinical follow-up. The recurrence rate after 360 primary herniae was 3.3% (Ethilon 2.3%, PDS 4.3%) while 5.9% rerecurrences were found following operation for recurrent hernia (Ethilon 2.5%, PDS 8.9%). The differences in the recurrence rates following the use of polyamide or polydioxanone were not statistically significant. Complications occurred in 5.2%. The postoperative hospital stay averaged 3.8 days and work was resumed after a mean of 3.9 weeks.
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PMID:[Early results of transversalis-plasty. A prospective randomized comparison of non-resorbable and resorbable sutures]. 190 93

Wound complications cause significant morbidity in patients undergoing gastric restrictive procedures. Two randomized, prospective trials were done evaluating suture technique and material. A subcutaneous suction catheter was used for 48 hours in all patients. In Trial I a Polyglactin-910 (Vicryl) suture, #1 in size, was used. Patients were randomized between interrupted Smead-Jones far-far-near-near sutures and running sutures. Because hernia formation appeared excessive in both groups of patients, a second study was done comparing running #1 polydioxanone (PDS) and #1 polypropylene (Prolene) suture. Hernia formation was excessive in this group as well. The authors conclude running and interrupted closures are of equal reliability. Hernia formation was excessive in both groups. The type of suture material used in these studies was inconsequential. A better method of closure is needed in morbidly obese patients to achieve less postoperative hernia formation.
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PMID:Incisional closure in morbidly obese patients. 249 14

In 114 and 108 patients who were operated upon the biliary tract with a subcostal incision and closed in one layer with Polydioyanone (PDS) and Polyglyconate (Maxon), the authors analysed the frequency of the complications in the healing of the operative wound. A superficial infection in the wound appeared in 1% and 0.9% of the patients in the PDS and Maxon group, while a deep infection of the wound appeared in 0.8% and 0% (P less than 0.05). In "contaminated" wound patients, the frequency of the deep infection of the wound was not significantly larger than the "clean" operations (P less than 0.05). The total frequency of the deep infection of the wound in 222 patients was 0.4%. There was no dehiscence of the wound abscesses or ligature fistulas. 4 months following surgery 92% and 90% of the patients from the PDS and Maxon group were checked; an incisional hernia was preceded by an infection of the surgical wound in both the PDS (0.9) and Maxon (1%) group. Risk-factors (older patients, sex, overweight and icterus) did not have any effect on the healing of the wounds. In 66% of the patients of the PDS and 62% of the Maxon group, the gallbladder bed was not drained. The difference in the development of complications in the healing of the surgical wound between the two drained groups was not statistically significant (P less than 0.5). With a one layer closure of the subcostal incision with PDS or Maxon, complications in the healing of the wound were significantly reduced. The purpose of our study was: a clinical evaluation and comparison of the two monofilament absorptive suture materials-Polydioxanone (PDS) and Polyglyconate (Maxon) during a one layer closure of surgical interventions on the biliary tract, and evaluation of certain risk-factors in the healing of the surgical wounds.
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PMID:[Single-layer closure of a subcostal incision using a monofilament absorbable suture material--comparison of polydioxanone (PDS) and polyglyconate (Maxon)]. 249 45

The effectiveness of using an absorbable suture material for continuous closure of abdominal wounds, especially contaminated wounds, has not yet been determined. Thus, the present study was conducted to investigate the wound complications that developed following continuous closure of clean and contaminated abdominal wounds using polydioxanone (PDS), compared with those that developed following interrupted closure using braided silk. Running closure using PDS was performed in 152 patients (PDS group), while 280 patients who underwent interrupted closure using braided silk served as controls (SILK group). The occurrence rates of wound dehiscence, early wound infection, and incisional hernia did not differ significantly between the two groups; however, the incidence of late suture sinus formation in the PDS group (1.3%) was significantly lower than that in the SILK group (7.1%). Moreover, late suture sinus formation following PDS suturing healed within 1 week after percutaneous drainage alone without removal of suture strings, whereas late suture sinus following braided silk suturing took an average of 16 days to heal and required removal of the infected suture strings in all 20 patients. These findings indicate the potential usefulness of PDS as a suture material to achieve running closure of clean or contaminated abdominal wounds.
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PMID:Running closure of clean and contaminated abdominal wounds using a synthetic monofilament absorbable looped suture. 1048 28

The object of the present study was to assess the value and outcome of needlescopy in the treatment of inguinal hernia (IH) in 150 children operated upon in Al-Mishary Hospital, Riyadh, between October 1997 and October 1999. Their ages ranged between 6 and 96 months, (mean 61.6 +/- 28.32 months). There were 130 males and 20 females; 81 (54%) presented with a right-sided IH and among these patients a hidden contralateral hernia was diagnosed in 12 cases (8%). A left-sided IH was present in 30 (20%) bilateral IHs in 19 cases (12.66%), a recurrent hernia in 15 (10%), and an incarcerated hernia in 5 (3.33%). All patients were subjected to needlescopic herniotomy using a 2.7-mm telescope and two 2-mm needle holders to close the internal ring with a 4/0 PDS suture. The mean duration of surgery was 20.6 +/- 4.65 min for unilateral and 26.4 +/- 1.6 min for bilateral hernia repair. The mean hospital stay was 18 +/- 3.23 h. The study showed that laparoscopic closure of the internal ring in children is feasible, easy, and preferable to open surgery. The fact that laparoscopy can diagnose a hidden contralateral hernia is an additional advantage.
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PMID:Needlescopic inguinal hernia repair in children. 1195 83

Inguinal hernia repair, according to Lichtenstein, is very popular due to its minimal invasiveness (local anaesthesia), easy and reproducible technique, low recurrence rate, and low morbidity. However, recent publications demonstrate an elevated rate of chronic irritations and pain, probably due to tension or nerve compression by the fixing sutures. We, therefore, established a concept to avoid these sutures by attaching the prosthesis with glue. After a pilot study, a randomised prospective trial was started. The aim of our study was to compare the results of the classical Lichtenstein repair (group 1) vs the "Sutureless Lichtenstein" (group 2) in terms of postoperative complications and recurrences. Operative access and management of the hernial sac was equal to Lichtenstein for both groups. In group 1, we sutured the mesh with PDS 2/0; in group 2, the mesh was glued with n-butyl-cyanoacrylate. In both groups, the operation was then completed according to Lichtenstein, and unrestricted activity was allowed after 2 weeks. A total of 46 patients have been operated on. The follow-up results at 3 weeks and [3 months] were: group 1 ( n=24) vs group 2 ( n=22): recurrences 0 [0] vs 0 [0], minor pain 8 [4] vs 4 [1], local numbness 14 [10] vs 10 [6]. No adhesive-related complications were seen. Patients will be followed for 2 years. The results in group 2 were excellent, and there was no difference vs group 1. Furthermore, there was a tendency for better results in group 2. These results are very promising and justify a continuation of the study.
Hernia 2003 Jun
PMID:Sutureless Lichtenstein: first results of a prospective randomised clinical trial. 1529 Jun 15

Pain following implantation of a total hip endoprosthesis is described in the literature with an incidence of 1-17.6%, depending on the type of prosthesis. The underlying causes are numerous; the primary reasons for such pain are septic and nonseptic loosening of the prosthesis, periarticular heterotopic ossifications, or trochanteric bursitis. Less common reasons are muscular hernia, squeezing of the joint capsule, distal nerve lesions, stress fractures, compartment syndromes, or neoplasia.One can find only a few reports about tendinitis of the iliopsoas muscle as a cause for pain following implantation of an endoprosthesis in total hip arthroplasty. We now report about a female patient with therapy-resistant pain after total hip replacement, caused by tendinitis of the iliopsoas muscle. We introduce the transpositioning of this tendon from the lesser trochanter to the proximal anterior femur and bony refixation with a PDS cord as a new operative treatment.
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PMID:[Iliopsoas tendinitis--rare cause of pain following implantation of a total hip endoprosthesis]. 1613 94

The aim of this prospective study was to set up and evaluate a technique allowing, by the mean of a memory ring, easy placement of the patch in the preperitoneal space (PPS), directly via the hernia orifice, so as to associate the advantages of the preperitoneal patch, anterior approach and minimally invasive surgery. The memory-ring patch was made by basting a PDS cord around a 14 x 7.5 cm oval shaped polypropylene mesh. The hernia sac was dissected, blunt dissection of the PPS was carried out through the hernia orifice and the patch was introduced in the PPS via the orifice. Spreading of the patch in the PPS was facilitated by the memory-ring. One hundred and twenty nine hernias, classified as Nyhus Type IIIa, IIIb and IV, were operated on 126 patients; 11 were big pantaloon or sliding hernias. The anesthesia was spinal in 116 cases and local in 10 cases. There were three benign postoperative complications (2.3%) related to the hernia repair. Ninety six percent of the patients were evaluated with a mean follow up of 24.5 months (12-42). Two recurrences (1.6%) occurred, 7 patients (5.6%) felt some degree of light pain, but not any case of disabling pain was observed. This technique offers many advantages. It is tension-free and almost sutureless. The patch is placed in the PPS through the hernia orifice without any remote opening in the abdominal wall. The patch applied directly to the deep surface of the fascia reinforces the weak inguinal area by restoring the normal anatomic disposition. The good preliminary results are encouraging and justify further randomized evaluation.
Hernia 2006 Jun
PMID:Inguinal hernia: preperitoneal placement of a memory-ring patch by anterior approach. Preliminary experience. 1689 41

Laparoscopic placement of the Kugel patch using a preperitoneal approach is the ideal method for hernioplasty repair because it is less invasive than the conventional open method. We first used a laparoscopic total extraperitoneal approach to place the Kugel patch, which is similar to the open approach; however, we encountered technical difficulty. We then used a laparoscopic intraperitoneal onlay approach. We performed laparoscopic hernioplasty using the Composix Kugel Patch in 5 patients. All 5 had a monolateral hernia; 1 case was recurrent. Only the polypropylene side of the mesh was fixed with titanium spiral tacks. An additional 3-0 polydioxanone (PDS) suture was used to prevent migration of the intra-abdominal organs and to fix the mesh to the abdominal wall. No intraoperative complications occurred, and no conversion was necessary. The mean duration of surgery was 77 minutes. No postoperative complications were observed, except for one small seroma. Four patients were administered intravenous analgesics after the first 24 hours of surgery. The results indicate that the intraperitoneal onlay approach may be feasible, safe, and effective for the treatment of inguinal hernias, especially recurrent hernias. This approach has been shown to be safer than other more commonly performed laparoscopic hernioplasties (e.g., transabdominal preperitoneal repair and total extraperitoneal repair).
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PMID:Laparoscopic inguinal hernia repair with the Composix Kugel Patch. 2048 Aug 41


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