Chronic Groin Pain (Inguinodynia) following inguinal hernia repair is a significant,though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However,moderate to ...Chronic Groin Pain (Inguinodynia) following inguinal hernia repair is a significant,though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However,moderate to severe pain persisting more than 3 mo after inguinal herniorrhaphy should be considered as pathological. The major reasons for chronic groin pain have been identified as neuropathic cause due to inguinal nerve(s) damage or non-neuropathic cause due to mesh or other related factors. The symptom complex of chronic groin pain varies from a dull ache to sharp shooting pain along the distribution of inguinal nerves. Thorough history and meticulous clinical examination should be performed to identify the exact cause of chronic groin pain,as there is no single test to confirm the aetiology behind the pain or to point out the exact nerve involved. Various studies have been performed to look at the difference in chronic groin pain rates with the use of mesh vs non-mesh repair,use of heavyweight vs lightweight mesh and mesh fixation with sutures vs glue. Though there is no convincing evidence favouring one over the other,lightweight meshes are generally preferred because of their lesser foreign body reaction and better tolerance by the patients. Identification of all three nerves has been shown to be an important factor in reducing chronic groin pain,though there are no well conducted randomised studies to recommend the benefits of nerve excision vs preservation. Both nonsurgical and surgical options have been tried for chronic groin pain,with their consequent risks of analgesic sideeffects,recurrent pain,recurrent hernia and significant sensory loss. By far the best treatment for chronic groin pain is to avoid bestowing this on the patient by careful intra-operative handling of inguinal structures and better patient counselling pre-and post-herniorraphy.展开更多
With flax fabric as the reinforcement and unsaturated polyester as the matrix,composites of two,three,and four layers were fabricated respectively by the vacuum assisted resin infusion(VARI)technique.Tensile strength ...With flax fabric as the reinforcement and unsaturated polyester as the matrix,composites of two,three,and four layers were fabricated respectively by the vacuum assisted resin infusion(VARI)technique.Tensile strength of the composites after being saturated in the water for different durations was tested.The tensile strength of the two-layer composites was decreased after being soaked in the water for two,three,and six month,respectively.For the three and four layers specimens,the tensile strength was decreased initially with water treatment.After reaching the minimum,the tensile strength was increased.Scanning electron microscopy(SEM)confirmed that it might be contributed to the thickness of the two-layer composites.The thinner specimen is easier to be damaged by the penetrated moisture owing to the delamination between the fiber and the matrix after water immersion.For the three and four layers specimens,their contradictory tensile strength suggests that the thicker specimen can delay the moisture permeation and is of better water durability.展开更多
文摘Chronic Groin Pain (Inguinodynia) following inguinal hernia repair is a significant,though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However,moderate to severe pain persisting more than 3 mo after inguinal herniorrhaphy should be considered as pathological. The major reasons for chronic groin pain have been identified as neuropathic cause due to inguinal nerve(s) damage or non-neuropathic cause due to mesh or other related factors. The symptom complex of chronic groin pain varies from a dull ache to sharp shooting pain along the distribution of inguinal nerves. Thorough history and meticulous clinical examination should be performed to identify the exact cause of chronic groin pain,as there is no single test to confirm the aetiology behind the pain or to point out the exact nerve involved. Various studies have been performed to look at the difference in chronic groin pain rates with the use of mesh vs non-mesh repair,use of heavyweight vs lightweight mesh and mesh fixation with sutures vs glue. Though there is no convincing evidence favouring one over the other,lightweight meshes are generally preferred because of their lesser foreign body reaction and better tolerance by the patients. Identification of all three nerves has been shown to be an important factor in reducing chronic groin pain,though there are no well conducted randomised studies to recommend the benefits of nerve excision vs preservation. Both nonsurgical and surgical options have been tried for chronic groin pain,with their consequent risks of analgesic sideeffects,recurrent pain,recurrent hernia and significant sensory loss. By far the best treatment for chronic groin pain is to avoid bestowing this on the patient by careful intra-operative handling of inguinal structures and better patient counselling pre-and post-herniorraphy.
基金Project of Tianjin Science and Technology Committee,China(No.043104711)Project of Educational Committee of Liaoning Province,China(No.2006B013)
文摘With flax fabric as the reinforcement and unsaturated polyester as the matrix,composites of two,three,and four layers were fabricated respectively by the vacuum assisted resin infusion(VARI)technique.Tensile strength of the composites after being saturated in the water for different durations was tested.The tensile strength of the two-layer composites was decreased after being soaked in the water for two,three,and six month,respectively.For the three and four layers specimens,the tensile strength was decreased initially with water treatment.After reaching the minimum,the tensile strength was increased.Scanning electron microscopy(SEM)confirmed that it might be contributed to the thickness of the two-layer composites.The thinner specimen is easier to be damaged by the penetrated moisture owing to the delamination between the fiber and the matrix after water immersion.For the three and four layers specimens,their contradictory tensile strength suggests that the thicker specimen can delay the moisture permeation and is of better water durability.
