Comparison of Bursting Pressure of Abdominal Wall Defects Repaired by Three Conventional Techniques

Seror, Dan; Nissan, Aviram; Spira, Ram M.; Feigin, Elad; Udassin, Raphael; Freund, Herbert R.
November 2003
American Surgeon;Nov2003, Vol. 69 Issue 11, p978
Academic Journal
Still debated are the appropriate techniques for the repair of abdominal wall defects and the methods used to measure their strength. Although tension has been used in many studies to test wound strength, bursting pressure reflects more accurately the pathophysiology of wound dehiscence. The aim of the current study was to evaluate three different techniques for closure of abdominal wall defects using a new and more accurate device for bursting pressure measurements. Full thickness abdominal wall defects measuring 2 cm² were created in 43 anesthetized rats randomly assigned to three groups: simple primary closure (n = 15), Mayo repair (n = 14), and primary closure reinforced with a mesh (n = 14). Thirty days after surgery, the rats were sacrificed. The abdominal wall was fully excised and placed over a bursting chamber made of a metal cylinder connected to a carbon dioxide source with a control valve and a manometer. Gas was gradually released while the pressure was recorded until bursting occurred. Disruption of all closures occurred at the point where the suture itself penetrated the tissue. The average bursting pressure was 1383 ± 299 mm Hg for the primary closure group, 1200 ± 409 mm Hg for the mesh reinforcement group, and 1607 ± 337 mm Hg for the imbrication repair (Mayo) group (P < 0.03). The data suggests an advantage for the Mayo repair over the other two repairs. The bursting chamber tested is a new and more reliable method to study techniques and conditions influencing the strength of abdominal wall closure.


Related Articles

  • Abdominal Wall Endometriosis: Report Of A Case And How Much We Know About It? Thapa, Amit; Kumar, Anand; Gupta, Saroj // Internet Journal of Surgery;2007, Vol. 9 Issue 2, p30 

    Endometriosis is a common gynaecological condition that sometimes presents to general surgeons as a lump in the abdomen. It can pose a diagnostic dilemma and should be in the differential diagnosis of lumps in the abdomen in females. Diagnosis is usually made on histology. We discuss a case of...

  • The duodenal fossae: anatomic study and clinical correlations. Peltier, Johann; Le Gars, Daniel; Page, Cyril; Yzet, Thierry; Laude, Maurice // Surgical & Radiologic Anatomy;Nov2005, Vol. 27 Issue 4, p303 

    The aim of this study was to present anatomic macroscopic aspects and the relationship between the duodenum and the posterior abdominal wall. The authors describe anatomic types of peritoneal duodenal fossae and stress some points of surgical importance. Twenty-four cadavers, fixed in formalin,...

  • The Role of Maternal Stress in Early Pregnancy in the Aetiology of Gastroschisis: An Incident Case Control Study. Palmer, Stephen R.; Evans, Annette; Broughton, Hannah; Huddart, Simon; Drayton, Mark; Rankin, Judith; Draper, Elizabeth S.; Cameron, Alan; Paranjothy, Shantini // PLoS ONE;Nov2013, Vol. 8 Issue 11, p1 

    Objective:The incidence of gastroschisis, a congenital anomaly where the infant abdominal wall is defective and intestines protrude from the abdominal cavity, is increasing in many countries. The role of maternal stress in some adverse birth outcomes is now well established. We tested the...

  • Immediate Laparoscopic Repair of a Traumatic Abdominal Wall Hernia in a 2-Year-Old Child. Pimpalwar, Ashwin; Joseph, Jacob // Journal of Laparoendoscopic & Advanced Surgical Techniques;Nov2011, Vol. 21 Issue 9, p881 

    Traumatic abdominal wall hernia in children with intact skin is rare. This type of hernia is caused by blunt trauma abdomen that does not penetrate the skin. These hernias have been repaired in adults by open repair. We report the first laparoscopic repair of this condition in a 2-year-old child...

  • A novel technique for fascial fixation of laparoscopic adjustable gastric band ports. Eid, G. M.; Gourash, W.; Collins, J. L. // Surgical Endoscopy;Apr2006, Vol. 20 Issue 4, p697 

    Access port dislodgement after laparoscopic adjustable gastric banding is a recurring problem that often requires operative revision. Securing the port to the abdominal wall fascia in the traditional way with standard instruments is challenging in obese patients due to a thick abdominal wall....

  • Sir Ganga Ram Hospital classification of groin and ventral abdominal wall hernias. Chowbey, Pradeep K.; Khullar, Rajesh; Mehrotra, Magan; Sharma, Anil; Soni, Vandana; Baijal, Manish // Journal of Minimal Access Surgery;Sep2006, Vol. 2 Issue 3, p106 

    Background: Numerous classifications for groin and ventral hernias have been proposed over the past five to six decades. The old, simple classification of groin hernia in to direct, inguinal and femoral components is no longer adequate to understand the complex pathophysiology and management of...

  • Light weight meshes in incisional hernia repair. Schumpelick, Volker; Klinge, Uwe; Rosch, Raphael; Junge, Karsten // Journal of Minimal Access Surgery;Sep2006, Vol. 2 Issue 3, p117 

    Incisional hernias remain one of the most common surgical complications with a long-term incidence of 10-20%. Increasing evidence of impaired wound healing in these patients supports routine use of an open prefascial, retromuscular mesh repair. Basic pathophysiologic principles dictate that for...

  • Pancreas Microenvironment Promotes VEGF Expression and Tumor Growth: Novel Window Models for Pancreatic Tumor Angiogenesis and Microcirculation. Tsuzuki, Yoshikazu; Carreira, Carla Mouta; Bockhorn, Maximilian; Lei Xu; Jain, Rakesh K.; Fukumura, Dai // Laboratory Investigation (00236837);Oct2001, Vol. 81 Issue 10, p1439 

    Pancreatic cancer has a poor prognosis, and treatment strategies based on preclinical research have not succeeded in significantly extending patient survival. This failure likely stems from the general lack of information on pancreatic tumor physiology, attributable to the difficulties in...

  • Nerve degeneration in inguinal hernia specimens. Amato, G.; Ober, E.; Romano, G.; Salamone, G.; Agrusa, A.; Gulotta, G.; Bussani, R. // Hernia;Feb2011, Vol. 15 Issue 1, p53 

    Background: The histological study of the herniated inguinal area is rare in the literature. This report is focused on the detection of structural changes of the nerves within tissues bordering the inguinal hernia of cadavers. Their physiopathological consequences are hypothesized. Materials and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics