Samuel C Lien1, Yaxi Hu2, Adi Wollstein2, Michael G Franz3, Shaun P Patel2, William M Kuzon4, Melanie G Urbanchek5. 1. Section of Plastic Surgery, University of Washington Medical Center, Seattle, WA. 2. Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI. 3. Section of General Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI. 4. Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI; Ann Arbor Veterans Administration Medical Center, Ann Arbor, MI. 5. Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI. Electronic address: melurban@umich.edu.
Abstract
BACKGROUND: Incisional hernias are a complication in 10% of all open abdominal operations and can result in substantial morbidity. The purpose of this study was to determine whether inhibiting abdominal muscle contraction influences incisional hernia formation during the fascial healing after laparotomy. We hypothesized that decreasing the deformation of the abdominal musculature would decrease the size or occurrence of an incisional hernia. METHODS: Using an established rat model for incisional hernia, a laparotomy through the linea alba was closed with 1 mid-incision, fast-absorbing suture. Three groups were compared: a sham group (sham; n = 6) received no laparotomy, and the saline hernia (SH; n = 6) and Botox hernia (BH; n = 6) groups were treated once with equal volumes of saline or botulinum toxin (Botox, Allergan) before the incomplete laparotomy closure. On postoperative day 14, the abdominal wall was examined for herniation and adhesions, and contractile forces were measured for abdominal wall muscles. RESULTS: No hernias developed in the sham rats. Rostral hernias developed in all SH and BH rats. Caudal hernias developed in all SH rats, but in only 50% of the BH rats. Rostral hernias in the BH group were 35% shorter and 43% narrower compared with those in the SH group (P < .05). The BH group had weaker abdominal muscles compared with the sham and SH groups (P < .05). CONCLUSION: In our rat model, partial paralysis of abdominal muscles decreases the number and size of incisional hernias. These results suggest that contractions of the abdominal wall muscle play a role in the pathophysiology of the formation of incisional hernias. Published by Elsevier Inc.
BACKGROUND: Incisional hernias are a complication in 10% of all open abdominal operations and can result in substantial morbidity. The purpose of this study was to determine whether inhibiting abdominal muscle contraction influences incisional hernia formation during the fascial healing after laparotomy. We hypothesized that decreasing the deformation of the abdominal musculature would decrease the size or occurrence of an incisional hernia. METHODS: Using an established rat model for incisional hernia, a laparotomy through the linea alba was closed with 1 mid-incision, fast-absorbing suture. Three groups were compared: a sham group (sham; n = 6) received no laparotomy, and the salinehernia (SH; n = 6) and Botox hernia (BH; n = 6) groups were treated once with equal volumes of saline or botulinum toxin (Botox, Allergan) before the incomplete laparotomy closure. On postoperative day 14, the abdominal wall was examined for herniation and adhesions, and contractile forces were measured for abdominal wall muscles. RESULTS: No hernias developed in the sham rats. Rostral hernias developed in all SH and BHrats. Caudal hernias developed in all SH rats, but in only 50% of the BHrats. Rostral hernias in the BH group were 35% shorter and 43% narrower compared with those in the SH group (P < .05). The BH group had weaker abdominal muscles compared with the sham and SH groups (P < .05). CONCLUSION: In our rat model, partial paralysis of abdominal muscles decreases the number and size of incisional hernias. These results suggest that contractions of the abdominal wall muscle play a role in the pathophysiology of the formation of incisional hernias. Published by Elsevier Inc.
Authors: V Annese; G Bassotti; G Coccia; M Dinelli; V D'Onofrio; G Gatto; G Leandro; A Repici; P A Testoni; A Andriulli Journal: Gut Date: 2000-05 Impact factor: 23.059
Authors: Lucas Torres Oliveira; Felipe Futema Essu; Gustavo Heluani Antunes de Mesquita; Yuri Justi Jardim; Leandro Ryuchi Iuamoto; Fábio Yuji Suguita; Diego Ramos Martines; Fernanda Nii; Daniel Reis Waisberg; Alberto Meyer; Wellington Andraus; Luiz Augusto Carneiro D'Albuquerque Journal: Int J Surg Case Rep Date: 2017-10-12