医药卫生切口疝ppt课件.pptVIP

Classification and surgical treatmentof incisional hernia;Introduction ;Methods; Results;Question 1: The definition of the incisional hernia;Question 2: The classification of incisional hernias;According to localisation ;According to size;differentiate between the “false” and the “real” fascial gap;According to recurrence;According to the situation at the hernia gate;According to symptoms;Question 3:  Should the ‘simple’ reconstruction of incisional hernias still be performed? ;Table 1 Results of ‘simple’ reconstruction of incisional hernias (fasciaduplication/adaptation);simple reconstruction with unacceptably high recurrence rates the development of new tissue-compatible, prosthetic materials additional strengthening of the frontal abdominal wall by implantation of allo- and autoplastic material should be obligatory. the simple reconstructions are less time consuming and seem to have fewer complications. ;the simple fascia-duplication can no longer be regarded as the “golden standard”. the fascia-duplication should only be used for small incisional hernias;Question 4: Pros and cons of prefascial prosthetic implantation;The following technique of onlay implantation was recommended;5. Detachment of adherent gut tissue. 6. Closure of the hernial gap by fascia adaptation with a non-resorbing suture in one of the following techniques (continuous suture, single knot suture, figure of eight suture).;7. Onlay implantation of a prepared and already cut prosthesis. The recommended distance from the suture line is 5 cm in all directions. The implant should be fixed to the aponeurosis without tension, with an non-resorbing suture material, or with Stapler. The recommended technique is a circular suture after fixing the four edges of the implant. ;;Table 2 Results of prefascial prosthetic repair (Chevrel technique; onlay);The following questions were discussed;According to the experts;Question 5: Pros and cons of subfascial prosthetic repair (