• Archives of Plastic Surgery
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• 제50권6호
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• pp.535-540
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• 2023

Background Abdominoplasty with abdominal plication increases intra-abdominal pressure (IAP) and has been previously associated with limited diaphragmatic excursion and respiratory dysfunctions. Many factors found in abdominoplasties and among postbariatric patients predispose them to a higher occurrence. This study aims to evaluate the impact of abdominal plication among postbariatric patients, assess whether the plication increases their IAP, and analyze how these IAP correlate to their postoperative outcome. Methods This prospective study was performed on all patients who underwent circumferential Fleur-De-Lis abdominoplasty. For this intended study, the IAP was measured by an intravesical minimally invasive approach in three stages: after the initiation of general anesthesia, after a 10-cm abdominal wall plication and skin closure, and 24 hours after the procedure. Results We included 46 patients, of which 41 were female and 5 were male. Before the bariatric procedure, these patients had an average maximum weight of 121.4 kg and an average maximum body mass index of 45.78 kg/m²; 7 were grade I obese patients, 10 were grade II, and 29 were grade III. Only three patients were operated on with a gastric sleeve and 43 with gastric bypass. We presented six patients with transitory intra-abdominal hypertension in the first 24 hours, all of them from the grade I obesity group, the highest presented was 14.3 mm Hg. We presented 15% (7/46) of complication rates, which were only four seroma and five dehiscence; two patients presented both seroma and wound dehiscence. Conclusion Performing a 10-cm abdominal wall plication or greater represents a higher risk for intra-abdominal hypertension, slower general recovery, and possibly higher complication rate in patients who presented a lower degree of obesity (grade I) at the moment of the bariatric surgery.

• 대한한방내과학회지
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• 제39권3호
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• pp.426-442
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• 2018

Objective: This study aimed to compare the effects of Zusanli and nonacupoint electroacupuncture stimulation on ultrasonographic gastric emptying and vital signs in eight healthy participants. Gastric emptying and its rate of change were analyzed to search for correlation with physical characteristics such as body mass index (BMI), sternocostal angle, and abdominal wall thickness. Methods: Eight healthy participants with no gastrointestinal disorders were enrolled in this study. Each participant went through three abdominal sonographies for gastric emptying assessment. At the second and third visits, participants received Zusanli and nonacupoint electroacupuncture stimulation in a random order. During the study period, we examined the BMI, sternocostal angle, and abdominal wall thickness of all participants. Vital signs (blood pressure, heart rate, and temperature) were also examined before and after the electroacupuncture stimulation. Results: Electroacupuncture stimulation at Zusanli significantly improved gastric emptying when compared to nonacupoint stimulation. Gastric emptying showed a positive correlation with BMI, sternocostal angle, and abdominal wall thickness, but this correlation was statistically insignificant. The improvement rate of gastric emptying by Zusanli electroacupuncture stimulation showed a positive correlation with BMI and sternocostal angle and a negative correlation with abdominal wall thickness. However, such results were also statistically insignificant. Among vital signs, only heart rate showed a significant decrease according to Zusanli electroacupuncture stimulation. Conclusions: A significant effect of Zusanli electroacupuncture was confirmed through ultrasonographic gastric emptying in healthy participants.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.542-547
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• 2014

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.

• Journal of Trauma and Injury
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• 제25권2호
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• pp.63-66
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• 2012

Resection of the bowel is necessary for the repair of a ventral hernia after recovery from trauma in some cases. In such instances, polyester or polypropylene meshcannot be used due to the possibility of infection; we had to use biological mesh instead. We report a case in which a traumatic hernia was repaired with Permacol (Covidien, Norwalk, CT, USA). A 42-year-old male patient had been injured by a factory machine seven months prior to admission. At that time, he had abdominal wall injury and small bowel perforation. His abdominal wall had been a defect after operation. A CT scan of the abdomen showed that the left abdominal wall, which is lateral to left rectus abdominis muscle had only one muscle layer, an external oblique muscle, and that a previous abdominal incision had a defect along the entire incision. During the exploration, 10 cm of small bowel was removed due to firm adhesion to the previous surgical scar. Permacol mesh was applied and fixed with transfascial fixations and tacks by using the intraperitoneal onlay mesh technique. There were no complications after the surgery and the patient was discharged without any problems.

• 한국동물위생학회지
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• 제21권4호
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• pp.407-411
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• 1998

Aspergillosis, caused by infection with Aspergillus fumigatus and less commonly by other Aspergillus species, is a prevalent and costly respiratory disease of poultry, In a flock of chicks, the number of birds, 4∼5 months old, had become gradually emaciated and subsequently died. Gross necropsy revealed multiple granulomatous masses on the abdominal serosa. The masses, 4∼15 mm in size, were attached on mainly intestinal wall. Also, the smaller masses in size were on mesentery and pancreas. However, only a few small white nodules were scattered throughout liver and lung in few samples. Microscopically, the mass were granulomatous with a central area of necrosis containing numerous septate, branched fungal hypae consistent with Aspergillus sp. These were surrounded by macrophages, giant cells, lymphocytes and fibrous tissues. Nodular lesions of liver and lung were seemed to spread hemotogenously from intestine and the possible route of infection was speculated by oral. This report is a Aspergillus-induced granuloma limited to the serosa of abdominal cavity, especially of intestinal wall.

• The Korean Journal of Pain
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• 제26권2호
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• pp.191-194
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• 2013

Pseudoaneurysm of the abdominal wall is a possible but very rare clinical entity. It is a known complication of surgery, trauma, or arterial puncture, but it is rarely spontaneous. Even though it can usually present with a wide range of local symptoms, it can cause referred pain via spinal cord, which is cross-excited with afferent sympathetic nervous system. We report a case of right arm pain which was referred from a small abdominal pseudoaneurysm like a referred pain from gall bladder. This rare entity should be considered in the differential for pain management in case that the pain does not resolve with medication or interventional pain management.

• Toxicological Research
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• 제20권1호
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• pp.13-20
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• 2004

The purpose of this study is to compare the biocompatibility of commercial purity Ti, Ti-6AI-4V and Ti-6AI-7Nb alloy specimens with and without surface treatment in mouse abdominal connective tissue in vivo. Each metal was implanted into specific abdominal subdermal tissue site of female mouse. After 4 weeks, the implants were removed and abdominal tissues were fixed, dehydrated and embedded in glycol methacrylate resin. And the tissues were histologically prepared for microscopical evaluation. It was characterized by the presence of connective tissue with fibrous capsule surrounding the implant. The fibrous tissue surrounding the implant was studied to determine the biocompatibility of implanted metals. The average thickness of the fibrous capsule formed around the implant was much thinner for the hydrogen peroxide added hydrochloric acid solution-treated specimen than for the others. The results of this evaluation indicate that modification of the surface properties of titanium and titanium alloy implants changes the biological properties in the abdominal connective tissue. In conclusion, these observations suggest that the proper surface treatment performed in the study is effective for the improvement of biocompatibility.

• 한국전산유체공학회:학술대회논문집
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• 한국전산유체공학회 2008년도 춘계학술대회논문집
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• pp.10-12
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• 2008

Hemodynamic features of blood flow in the abdominal aorta aneurysm (AAA) are very important, because they are closely related with the rupture of aneurysm to death. It has been considered that the wall shear stress of blood flows influences the formation, growth, and rupture of AAA. On this account, it is important to understand the flow structure of blood in the aneurysm. In this study, the whole velocity field information inside a typical AAA was measured using an in vitro AAA model under the pulsatile flow condition. The vessel geometry was reconstructed based on the computerized tomography (CT) data of a patient. The AAA model was made by using a rapid prototyping (RP) method, based on the reconstructed vessel geometry. Velocity fields in the AAA model were measured at different pulsatile phases using a PIV (particle image velocimetry) system. As experimental results, a large-scale vortex is formed inside the AAA model and the vortices located near the AAA wall are supposed to increase the local pressure and wall shear stress. In this study, the AAA wall stress found to be was one of the most important governing parameters giving rise to the ruptured aneurysm.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2003년도 추계학술대회
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• pp.747-752
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• 2003

Many clinical studies have suggested that the blood flow in ideal geometry is involved in the development of atherosclerosis. This study simulated blood flow in the abdominal artery with real geometry to investigate MWSS(mean wall shear stress), AWSS(amplitude of wall shear stress) and OSI(oscillator shear index). The calculation grid for the real geometry was constructed by extracting the surface of arterial wall from CT(Computed Tomography) or MRI(Magnetic Resonance Imaging) sheets called as DICOM (Digital Imaging and Communications in Medicines). The calculated MWSS, AWSS and OSI are much different from those of ideal geometry calculation. The MWSS increased while the AWSS decreased. Many shear forces are related to shapes of gradient. This paper will give clinical datum where the MWSS, AWSS and OSI are strong or weak. The hemodynamic analysis based on real geometry can provide surgeons with more reliable information about the effect of blood flow.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.643-647
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• 2006

Purpose: The transverse rectus abdominis myocutaneous(TRAM) flap has become a mainstay of breast reconstruction. The chief disadvantage of the TRAM flap is its potential to create a weakness in the abdominal wall. Nowadays true hernia is less frequent, but bulging that appears at the muscle donor site, or at the contralateral side, or at the epigastric area is still remained as a problem. To prevent this complications, we have used synthetic mesh as well as abdominal muscle plication. Now we report the result of our methods. Methods: We started to use synthetic mesh and muscle plication as supplementary reinforcement for entire abdominal wall, after TRAM flap harvesting, in an attempt to stabilize it and achieve a superior aesthetic result since 2002. We observed complications of TRAM flap donor site, and compared our results (from January, 2002 to January, 2006) with other operator's result (before 2001) at the same hospital in aspect of incidence of abdominal complications. Results: 42 consecutive patients have been performed routine reinforcement with the extended mesh technique and muscle plication from January, 2002 to January, 2006. Mean patient follow up was 25.2 months. No hernia or mesh related infection were encountered and only one patient had a mild abdominal bulging. Nevertheless the our good results, there were no significant statistical differences were observed between two groups. Conclusion: We recommend the using of synthetic mesh and muscle plication for donor site reconstruction after TRAM flap breast reconstruction to improve strength as well as aesthetic quality of the abdominal wall.