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Onlay versus Sublay Mesh Repair for Ventral Hernia
Aly Saber,
Emad K. Bayumi
Issue:
Volume 4, Issue 1-1, January 2016
Pages:
1-4
Received:
6 August 2015
Accepted:
7 August 2015
Published:
8 September 2015
Abstract: Introduction: Ventral hernia repair is among the most common surgical operations performed worldwide and the two operative techniques most frequently used in case of ventral hernia are the onlay and sublay repair. However, it remains unclear which technique is superior. The aim of this study was to compare the outcome of the onlay versus sublay mesh repair for ventral hernia. Patients and Methods: A total of 200 patients with paraumbilical, epigastric and supraumbilical incisional hernias were divided into main two groups; A; onlay mesh repair and B; sublay mesh repair. End Points:The primary end point of the study was recurrence of the hernia, defined as a clinically detectable characteristic swelling and diagnosed by the two authors. The secondary end points were operative time, drainage time, seroma formation and purulent wound infection. Results: The mean operative time for onlay repair was 67.04 ± 13.19 minutes while in sublay group was 93.26 ± 24.94 minutes ranged from 60 to 140 minutes. As regard the drainage time, the mean total time in days was 7.47 ± 1.7 days in onlay repair while in sublay group was 4.5 ± 1.1 days. Seroma formation after suction drain removal was observed in 6% patients in group A and in 2% in group B. Purulent wound infection was observed in 8% and 4% patients in group A and B respectively treated with dressing and proper antibiotic according to culture tests. Disease recurrence was observed in 8 % and 3 % patients of group A and B respectively. Conclusion: Sublay mesh repair is a good alternative to onlay mesh repair that may be applicable to all forms of ventral hernia. The mesh related overall complication rate is low such as drainage time, seroma formation and wound infection as well as the low recurrence rate. The authors concluded for trials on sublay mesh repair with a large number of cases and a longer period of follow-up.
Abstract: Introduction: Ventral hernia repair is among the most common surgical operations performed worldwide and the two operative techniques most frequently used in case of ventral hernia are the onlay and sublay repair. However, it remains unclear which technique is superior. The aim of this study was to compare the outcome of the onlay versus sublay mes...
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Effect of Honey versus Icodextrin on Adhesion Reformation after Adhesiolysis: an Experimental Study in Rats
Aly Saber,
Mohammed H. Shekidef,
Aya Aly Saber
Issue:
Volume 4, Issue 1-1, January 2016
Pages:
5-10
Received:
6 August 2015
Accepted:
7 August 2015
Published:
8 September 2015
Abstract: Introduction: Although the process of de novo adhesion formation after operation has been fairly well established, adhesion reformation in a previously affected zone is still poorly understood. Honey was proved effective as an anti-adhesive agent in experimental animals. The aim of the present experimental study is to investigate the effect of HONEY on adhesion reformation prevention when compared with ICODEXTRIN in rats. Materials & Methods: 75 healthy male Sprague–Dawley rats having average weight250–300 g were divided into three groups for study: [25 rats for each], Honey, Icodextrin and control groups. Laparotomy was done carefully for not to disturb any adhesion could be attached to the previous laparotomy incision. Any adhesion band was dissected and divided gently and smoothly with sharp maneuver using fine surgical scissors. In case of groups A and B, three ml of Honey and Icodextrin were instillated, using sterile syringes; into the abdominal cavity before completing laparotomy wound closure to prevent escape of the material outside the peritoneal cavity. Results: Total adhesion score among the three groups showed statistically significant difference using the ANOVA test but when comparing group A and B,the difference is considered to be not statistically significant. Conclusion: Both icodextrin and honey has beneficial effect on reduction of the extent and severity of intraperitoneal adhesion reformation in our rat model for colonic anastomoses. Honey surpasses icodextrin regarding the total adhesion score and the score per animal.
Abstract: Introduction: Although the process of de novo adhesion formation after operation has been fairly well established, adhesion reformation in a previously affected zone is still poorly understood. Honey was proved effective as an anti-adhesive agent in experimental animals. The aim of the present experimental study is to investigate the effect of HONE...
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Role of Drainage of Preperitoneal Space in Postoperative Wound Sepsis
Emad K. Bayumi,
Aly Saber
Issue:
Volume 4, Issue 1-1, January 2016
Pages:
11-15
Received:
14 August 2015
Accepted:
15 August 2015
Published:
8 September 2015
Abstract: Introduction: The incidence of surgical site infection increases with the degree of abdominal contamination. Previous studied claimed the effectiveness of putting a negative suction drain in the subcutaneous space in prevention of wound infection and wound dehiscence in patients of peritonitis. Aim was to study the effect of drainage of preperitoneal space in postoperative wound infection. Patients and Methods: A total of 200 patients with secondary peritonitis due to perforated appendicitis, perforated duodenal ulcers and traumatic bowel injuries were divided into main two groups; group A; wound closure with preperitoneal submuscular suction drainage and group B; wound closure without drain. End Points: The end points of the study were wound infection and time off from work. Results: The overall rates of wound infection in were 19% and 24% in group A and B respectively. Therefore the mean total hospital stay in both groups was 8.48 ±3 and 14.76±4.41days respectively. In the other hand, the mean time to return work after being discharged from the hospital was 8.5 ± 1.13 in group A and 8.59 ± 1.1 in of group B. The mean time off from work was 16.98 ± 4.13 days in group A and 23.38 ± 5.51 days in group B. Conclusion: Incidence of surgical site infection is high in case of complicated appendicitis and has its direct effect on the extent of hospital stay and time off from work and those with drainage of preperitoneal space showed more time of hospital stay and more time off from work.
Abstract: Introduction: The incidence of surgical site infection increases with the degree of abdominal contamination. Previous studied claimed the effectiveness of putting a negative suction drain in the subcutaneous space in prevention of wound infection and wound dehiscence in patients of peritonitis. Aim was to study the effect of drainage of preperitone...
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Neoumbilical Reconstruction as an Adjuvant Procedure in Abdominoplasty
Issue:
Volume 4, Issue 1-1, January 2016
Pages:
16-18
Received:
3 September 2015
Accepted:
6 September 2015
Published:
17 September 2015
Abstract: Introduction: Neo-umbilicus construction is usually needed post abdominoplasty and in some techniques the umbilicus needs resection after repeated abdominoplasty. There are many techniques for umbilical reconstruction and the common objective of all these techniques is to create a new umbilicus that looks natural in terms of location, size and depth. The author in this study described a new and simple technique for umbilical reconstruction. Patients and methods: The present study included 50 cases who were subjected to abdominoplasty and neo-umbilicoplasty in Crimean Medical Academy named after S.I. Georgievsky Crimean Federal University named after V.I. Vernadsk Russia in department of general and gastrointestinal surgery. The study started from January 2010 to may 2015. End points: The primary end point of the study was the aesthetic appearance of the new umbilicus and the second end point was patient satisfaction of the operative outcome. Results: Over 50 cases of abdominoplasty we performed reconstruction of the umbilicus with a new and simple technique. There were 40 females and 10 males with age ranging from 28 to 52 years with the mean value as 40 ± 7.35 years. Conclusion: The technique for reconstruction of the umbilicus presented in the present study is a simple technique without complications, with long term success and good aesthetic appearance The new constructed umbilicus exhibits appropriate features of both depth and size and avoids the appearance of scarring and secondary stenosis.
Abstract: Introduction: Neo-umbilicus construction is usually needed post abdominoplasty and in some techniques the umbilicus needs resection after repeated abdominoplasty. There are many techniques for umbilical reconstruction and the common objective of all these techniques is to create a new umbilicus that looks natural in terms of location, size and dept...
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Pattern of Wound Complications and Postoperative Pain in Sublay versus Onlay Mesh Repair for Ventral Hernia
Aly Saber,
Adel R. Al-Masry
Issue:
Volume 4, Issue 1-1, January 2016
Pages:
19-23
Received:
3 September 2015
Accepted:
6 September 2015
Published:
17 September 2015
Abstract: Introduction: Apart from recurrence after ventral hernia repairs, other postoperative complications like seroma formation, hematoma, cellulitis, wound infection attributed largely to extensive dissection and tissue handling. Sublay technique has several advantages such as low rate of infection from subcutaneous tissues down to the mesh as it lies quite deep in the preperitoneal plane. Moreover the mesh implanted in the preperitoneal space unites and consolidates the anterior abdominal wall and also adheres to the posterior rectus sheath and renders it inextensible allowing no further herniation. The authors in this study tried to compare the pattern of wound complications and postoperative pain in sublay and onlay mesh repair for ventral hernia. Patients and Methods: A total of 200 patients with ventral hernias were enrolled and divided into main two groups; A and B. Group A patients were subjected to onlay mesh repair and Group B patients were subjected to sublay mesh repair. Operations were performed in Port-Fouad general hospital, Port-Fouad, Port-Said, Egypt and in the Al-Mahalla Al-Koubra general hospital, Al-Mahalla Al-Koubra, Egypt. End Points: The end points were of wound infection, mesh rejection and chronic postoperative pain. Results: There was no statistical difference between both groups regarding their demographic data such as age, sex, special habits and body mass index and co-morbidities. Patterns of mesh related wound complications as well as chronic postoperative pain were higher in onlay versus sublay repair with no statistical significance. Conclusion: sublay preperitoneal repair is a safe and an effective technique for ventral hernia surgery. Pattern of wound complications as postoperative wound infection, mesh removal and chronic pain are much less than when compared with the onlay maneuver.
Abstract: Introduction: Apart from recurrence after ventral hernia repairs, other postoperative complications like seroma formation, hematoma, cellulitis, wound infection attributed largely to extensive dissection and tissue handling. Sublay technique has several advantages such as low rate of infection from subcutaneous tissues down to the mesh as it lies q...
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Evaluation Symptoms Indices in Laryngopharyngeal Reflux Disease
Mohammed Tahir Ali,
Mohammed Rifaat Ahmed,
Aly Saber
Issue:
Volume 4, Issue 1-1, January 2016
Pages:
24-26
Received:
27 July 2015
Accepted:
28 July 2015
Published:
15 October 2015
Abstract: Objectives: to determine the indexes of the symptoms among patients laryngopharyngeal reflux disease. Design: A descriptive study. Setting: Suez Canal University Hospital, Ismailia, Egypt. Patients: 178 patients with symptoms of LFRD such as:- heart burn , Hoarseness of voice , persistent cough, globus pharyngeus, throat clearing. Intervention: patients were evaluated by ambulatory 24 hours pH monitoring, symptom intensity evaluation using the visual analog scale (VAS) , symptoms Frequency evaluation and index calculated by multiplication of the intensity and frequency the each symptom. Results: Heartburn was the most intensive typical symptom in the LPRD patients as mean intensity was 7.31 ± 1.02 points, mean HBI was 8.34 ± 0.96 points followed by persistence cough mean intensity was 6.81± 1.75 points, mean PCI was 7.12 ±1.28 points. Conclusion: LPRD patients mean indexes of atypical symptoms much higher than expected with a characteristic laryngoscopic findings are found.
Abstract: Objectives: to determine the indexes of the symptoms among patients laryngopharyngeal reflux disease. Design: A descriptive study. Setting: Suez Canal University Hospital, Ismailia, Egypt. Patients: 178 patients with symptoms of LFRD such as:- heart burn , Hoarseness of voice , persistent cough, globus pharyngeus, throat clearing. Intervention: pat...
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