Download e-book for kindle: Meshes: Benefits and Risks by L. M. Nyhus (auth.), Prof. Dr. med. Dr. h.c. Volker

By L. M. Nyhus (auth.), Prof. Dr. med. Dr. h.c. Volker Schumpelick, Dr. med. Lloyd M. Nyhus (eds.)

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Extra resources for Meshes: Benefits and Risks

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Last but not least, several studies concerning the connective tissue could demonstrate a disturbance of the coHagen metabolism with decreased ratio of collagen types I to III and increase of MMP-l and MMP-13, in patients developing inguinal hernia recurrences [5, 11]. In summary, the discrepancy between the clinical trials with excellent results and low recurrence rates and the epidemiological findings with the constant high rate of operations for recurrent hernias cannot be explained only with technical problems.

Data in the literature give differing results [19). Recurrent laparotomies via the same incision and the number of previous laparotomies on the other hand had a significant influence. We have to be aware that median laparotomies are the standard access to the abdominal cavity in emergency situations, in which often other cofactors for the development of IH are simultaneously present (anemia, contamination, ASA class 3). When only elective surgical procedures are analyzed in the literature, a significant influence is if the type of incision chosen cannot be found [1,26).

Influence of suture technique on laparotomy wound healing: An experimental study in the rat. Langenbeck's Arch Surg 2001;386:218-23 12. Hoer J, Anurov M, Titkova S, Klinge U, Tons Ch, Oettinger A, Schumpelick V. Influence of suture material and suture technique on collagen fibril diameters in midline laparotomies. Eur Surg Res 2000; 32: 359-367 13. Israelsson LA, Jonsson T. Incisional hernia after midline laparotomy: a prospective study. Eur J Surg 1996; 162: 125-9 14. Israelsson LA. The surgeon as a risk factor for complications of midline incisions.

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