The so-called 'burst abdomen' has been described for many years and is a well-known clinical condition, whereas the concept of the 'open abdomen' is relatively new. In clinical practice, both nosologic...The so-called 'burst abdomen' has been described for many years and is a well-known clinical condition, whereas the concept of the 'open abdomen' is relatively new. In clinical practice, both nosological entities are characterized by a complex spectrum of symptoms apparently disconnected, which in many cases poses a great challenge for surgical repair. In order to assess the management of these disorders in a more comprehensive and integral fashion, the concept of 'acute postoperative open abdominal wall'(acute POAW) is presented, which in turn can be divided into 'intentional' or planned acute POAW and 'unintentional' or unplanned POAW. The understanding of the acute POAW as a single clinical process not only allows a better optimization of the ther-apeutic approach in the surgical repair of abdominal wallrelated disorders, but also the stratification and collection of data in different patient subsets, favoring a better knowledge of the wide spectrum of conditions involved in the surgical reconstruction of the abdominal wall.展开更多
Polypropylene(PP)mesh is commonly used in abdominal wall repair due to its ability to reduce the risk of organ damage,infections and other complications.However,the PP mesh often leads to adhesion formation and does n...Polypropylene(PP)mesh is commonly used in abdominal wall repair due to its ability to reduce the risk of organ damage,infections and other complications.However,the PP mesh often leads to adhesion formation and does not promote functional tissue repair.In this study,we synthesized one kind of aldehyde Bletilla striata polysaccharide(BSPA)modified chitosan(CS)hydrogel based on Schiff base reaction.The hydrogel exhibited a porous network structure,a highly hydrophilic surface and good biocompatibility.We wrapped the PP mesh inside the hydrogel and evaluated the performance of the resulting composites in a bilateral 1×1.5cm abdominal wall defect model in rats.The results of gross observation,histological staining and immunohistochemical staining demonstrated the positive impact of the CS hydrogel on anti-adhesion and wound healing effects.Notably,the addition of BSPA to the CS hydrogel further improved the performance of the composites in vivo,promoting wound healing by enhancing collagen deposition and capillary rearrangement.This study suggested that the BSPA-modified CS hydrogel significantly promoted the anti-adhesion,anti-inflammatory and pro-angiogenesis properties of PP meshes during the healing process.Overall,this work offers a novel approach to the design of abdominal wall repair patches.展开更多
Blunt traumatic abdominal wall disruptions associated with evisceration (abdominal wall injury grade type Ⅵ) are very rare. We describe a case of large traumatic abdominal wall disruption with bowel evisceration and ...Blunt traumatic abdominal wall disruptions associated with evisceration (abdominal wall injury grade type Ⅵ) are very rare. We describe a case of large traumatic abdominal wall disruption with bowel evisceration and complete transection of jejunum and sigmoid colon that occurred after a 30-year-old male sustained run over injury to abdomen. Abdominal exploration and primary end to end jejuno-jejunal and colo-colic anastomosis were done. Staged management of giant abdominal wall defect was performed without any plastic reconstruction with good clinical outcome.展开更多
目的观察不同负压值的伤口负压吸引术(negative pressure wound therapy,NPWT)应用于开放性腹部伤口治疗中小肠壁出血面积变化。方法将12头家猪做正中切口,采用随机数字表法分为3组。分别行负压值为-50 mm Hg(A组)、-125 mm Hg(B组)及-2...目的观察不同负压值的伤口负压吸引术(negative pressure wound therapy,NPWT)应用于开放性腹部伤口治疗中小肠壁出血面积变化。方法将12头家猪做正中切口,采用随机数字表法分为3组。分别行负压值为-50 mm Hg(A组)、-125 mm Hg(B组)及-200 mm Hg(C组)的NPWT,持续NPWT 12、24、48 h后对小肠壁出血面积的变化分别进行拍照和量化。结果持续NPWT 12、24和48 h后小肠表面出血面积C组>B组>A组,差异有统计学意义(P<0.05﹚。结论负压值的大小与小肠壁出血面积的大小呈正向直线相关,实验中三组比较得出负压值为-125 mm Hg的NPWT具有较好的引流效果时,对小肠损伤较小。展开更多
文摘The so-called 'burst abdomen' has been described for many years and is a well-known clinical condition, whereas the concept of the 'open abdomen' is relatively new. In clinical practice, both nosological entities are characterized by a complex spectrum of symptoms apparently disconnected, which in many cases poses a great challenge for surgical repair. In order to assess the management of these disorders in a more comprehensive and integral fashion, the concept of 'acute postoperative open abdominal wall'(acute POAW) is presented, which in turn can be divided into 'intentional' or planned acute POAW and 'unintentional' or unplanned POAW. The understanding of the acute POAW as a single clinical process not only allows a better optimization of the ther-apeutic approach in the surgical repair of abdominal wallrelated disorders, but also the stratification and collection of data in different patient subsets, favoring a better knowledge of the wide spectrum of conditions involved in the surgical reconstruction of the abdominal wall.
基金the National Natural Science Foundation of China(No.32171345)the Hebei Provincial Natural Science Foundation of China(No.C2022104003)+4 种基金the Beijing Nova Programme Interdisciplinary Cooperation Project(No.20230484464)the Fok Ying Tung Education Foundation(No.141039)the Fund of Key Laboratory of Advanced Materials of Ministry of Education(No.AdvMat-2023-10)the International Joint Research Center of Aerospace Biotechnology and Medical Engineering,Ministry of Science and Technology of Chinathe 111 Project(No.B13003).
文摘Polypropylene(PP)mesh is commonly used in abdominal wall repair due to its ability to reduce the risk of organ damage,infections and other complications.However,the PP mesh often leads to adhesion formation and does not promote functional tissue repair.In this study,we synthesized one kind of aldehyde Bletilla striata polysaccharide(BSPA)modified chitosan(CS)hydrogel based on Schiff base reaction.The hydrogel exhibited a porous network structure,a highly hydrophilic surface and good biocompatibility.We wrapped the PP mesh inside the hydrogel and evaluated the performance of the resulting composites in a bilateral 1×1.5cm abdominal wall defect model in rats.The results of gross observation,histological staining and immunohistochemical staining demonstrated the positive impact of the CS hydrogel on anti-adhesion and wound healing effects.Notably,the addition of BSPA to the CS hydrogel further improved the performance of the composites in vivo,promoting wound healing by enhancing collagen deposition and capillary rearrangement.This study suggested that the BSPA-modified CS hydrogel significantly promoted the anti-adhesion,anti-inflammatory and pro-angiogenesis properties of PP meshes during the healing process.Overall,this work offers a novel approach to the design of abdominal wall repair patches.
文摘Blunt traumatic abdominal wall disruptions associated with evisceration (abdominal wall injury grade type Ⅵ) are very rare. We describe a case of large traumatic abdominal wall disruption with bowel evisceration and complete transection of jejunum and sigmoid colon that occurred after a 30-year-old male sustained run over injury to abdomen. Abdominal exploration and primary end to end jejuno-jejunal and colo-colic anastomosis were done. Staged management of giant abdominal wall defect was performed without any plastic reconstruction with good clinical outcome.
文摘目的观察不同负压值的伤口负压吸引术(negative pressure wound therapy,NPWT)应用于开放性腹部伤口治疗中小肠壁出血面积变化。方法将12头家猪做正中切口,采用随机数字表法分为3组。分别行负压值为-50 mm Hg(A组)、-125 mm Hg(B组)及-200 mm Hg(C组)的NPWT,持续NPWT 12、24、48 h后对小肠壁出血面积的变化分别进行拍照和量化。结果持续NPWT 12、24和48 h后小肠表面出血面积C组>B组>A组,差异有统计学意义(P<0.05﹚。结论负压值的大小与小肠壁出血面积的大小呈正向直线相关,实验中三组比较得出负压值为-125 mm Hg的NPWT具有较好的引流效果时,对小肠损伤较小。
