[Pathophysiology of the abdominal wall].
The use of biomaterials for closure of incisional hernias requires meshes adjusted to the physiological forces. The intraabdominal pressure is mainly influenced by the activity of the transverse muscles. The abdominal fascia of corpses withstands forces of 60-80 N/cm in horizontal and 20-30 N/cm in vertical direction; tearing of sutures occurs below 30 N/cm in horizontal direction. Assuming the abdominal cavity to be a thin hollow sphere, the rupture forces are approximately 4-16 N/cm for a diameter of 8-3 cm. The meshes currently in use are much stronger than this, rupturing at 40-100 N/cm. The curvature of the abdominal surface can be measured by 3D-photogrammetry and is highly significantly reduced following mesh implantation (t-test, 2-sided, P < 0.01). Reduction of the mesh material can decrease the rate of local wound complications and the stiffness of the abdominal wall.
Klinge
U
U
Chirurgische Klinik, RWTH Aachen.
Conze
J
J
Limberg
W
W
Brücker
C
C
Ottinger
A P
AP
Schumpelick
V
V
D000009:Abdominal Muscles / Q000503:physiopathology / Q000601:surgery*; D000818:Animals; D006555:Hernia, Ventral / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D006874:Hydrostatic Pressure; D007091:Image Processing, Computer-Assisted; D010780:Photogrammetry; D011183:Postoperative Complications / Q000503:physiopathology* / Q000601:surgery; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000503:physiopathology* / Q000601:surgery; D013536:Suture Techniques; D013537:Sutures
Pathophysiologie der Bauchdecken.