The contributions of Usher and others to the elimination of tension from groin herniorrhaphy.
Relaxing incisions (Wolfler 1892) were eventually shown (Read and McLeod, 1981) to reduce but not eliminate wound tension after sutured herniorrhaphy of the groin. Reinforcing prosthetics became widely shunned because of morbidity until Usher et al (1958) introduced polyethylene, then polypropylene mesh (1963) for preperitoneal tensionless repair of large defects. Excellent long-term results were obtained, with his technique, by Collier and Griswold (1967). Patt (1967) envisaged its application to primary hernia. Reis (1899) introduced early ambulation. However, it was not until Leithauser (1943), Blodgett (1946), and others showed immediate rising accelerated wound healing and reduced complications that Farquharson (1955) began outpatient hernioplasty (in 1950) under local anesthesia (Cushing 1900). Bellis (1964) followed, performing tensionless repair in 25%. Rodriguez and Phillips (1967) described office herniorrhaphy, 30% undergoing polypropylene mesh coverage without tension. Lichtenstein (1970) reported mesh onlay reinforcement for sutured repair of large defects, discharge was within 24 hours. Martin et al (1982) began (in 1972) to treat all inguinal herniation in adults with polypropylene mesh "to avoid recurrences". Newman did likewise, using tension-free placement (Rodriguez et al) in the subaponeurotic plane. Encountering resistance to publication ("real surgeons don't use mesh") he, in 1980, asked Lichtenstein to publish and popularize the technique. Kelly (1898) introduced plug prosthestic repair of femoral herniation. Drainer and Reid (1972) used polypropylene mesh from below under local anesthesia. Lichtenstein and Shore followed, treating recurrent inguinal defects similarly. Gilbert (1989) applied the technique to indirect herniae. Usher and others deserve recognition for their contributions to the elimination of tension from herniorrhaphy.
Read
Raymond C
RC
University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA. read@post.harvard.edu
D013502:General Surgery / Q000266:history*; D006552:Hernia, Inguinal / Q000266:history* / Q000601:surgery; D049673:History, 20th Century; D006801:Humans; D011126:Polypropylenes / Q000266:history*; D013526:Surgical Mesh / Q000266:history*
D011126:Polypropylenes
Surgery. 1946 Apr;19:498-503
21020304
AMA Arch Surg. 1959 Jan;78(1):138-45
13605405
Ind Med Surg. 1964 Oct;33:721-5
14215328
Int Surg. 1967 Apr;47(4):360-1
6033913
J R Coll Surg Edinb. 1972 Jul;17(4):253-60
5073913
Surg Gynecol Obstet. 1963 Aug;117:239-40
14048019
Ann Surg. 1985 Jun;201(6):705-11
3159353
Am Surg. 1967 Sep;33(9):715-6
5341001
Am J Surg. 1989 Mar;157(3):331-3
2919740
Am Surg. 1959 Oct;25:792-5
13840516
Surg Clin North Am. 1998 Dec;78(6):973-1006, vi
9927980
Int Surg. 1967 Dec;48(6):561-5
6064727
Surgery. 1959 Oct;46:718-24
13840514
Ann Surg. 1900 Jan;31(1):1-34
17860789
Arch Surg. 1967 May;94(5):734-6
6025910
Ann Surg. 1947 Jun;125(6):768-74
17858965
Am Surg. 1958 Dec;24(12):969-74
13606360
Lancet. 1955 Sep 10;269(6889):517-9
13252904
Br J Surg. 1967 Nov;54(11):917-20
4861742
Surg Gynecol Obstet. 1946 Oct;83:485-93
20997864
Int Surg. 1969 Aug;52(2):107-10
5793088
Rev Surg. 1968 Mar-Apr;25(2):95-100
5649776
Ann Surg. 1938 Apr;107(4):572-81
17857162
Am J Surg. 1974 Sep;128(3):439-44
4607074
Sem Hop. 1969 Jul 10;45(31):2182-4
4308673
Int Surg. 1986 Jul-Sep;71(3):154-8
2945797
Arch Surg. 1981 Apr;116(4):440-5
7011257
Am J Surg. 1957 Jul;94(1):1
13424862