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Abstract
The author calculated the pressure of sutures on the aponeurosis in cases of large
incisional hernia. The pressures were found to be very much higher than the highest
that occur physiologically. It is thought that this is the explanation of the high
frequency of recurrence after repair of incisional hernia. When this pressure is evenly
distributed over a much larger surface of aponeurotic tissue and applied at a location
about 2.5 cm. from the edges of the aponeurotic defect, the latter will have a relatively
intact circulation. Consequently, with the use of a closure device developed by Ton,9 healing can proceed undisturbedly. Furthermore, this method implies the eventual
removal of all nonabsorbable material after three to six weeks. Experience in 58 patients
with incisional hernia is described; only five recurrences are reported.
Also there appear to be both “soft” and “hard” types of aponeurosis in different patients.
Soft aponeurosis splits easily with moderate pull; this characteristic may explain
why some patients develop a hernia after a primary repair in the abdominal wall whereas
others do not.
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References
- A study of five hundred incisional hernias.J. Intern. Coll. Surg. 1962; 37: 125
- Grote littekenbreuken.Nederl. Tijdschr. Geneesk. 1968; 112: 1113
- Het ontstaan en de behandeling van littekenbreuken.Nederl. Tijdschr. Geneesk. 1970; 114: 461
- Physiology of connective tissue.Butterworths & Co., Ltd.,, London1967
- Physiology of connective tissue.Butterworths & Co., Ltd.,, Prague1967
- Surgical technic of closure for extremely large abdominal hernias.J. Int. Coll. Surg. 1958; 30: 638
- The healing of aponeurotic incisions.Brit. J. Surg. 1952; 40: 79
- The strength of wounds sutured with catgut and silk.Surg. Gynec. Obstet. 1933; 57: 309
- The effect of sutures on the strength of healing wounds.Amer. J. Surg. 1940; 49: 56
- Tijdelijke prothesen bij het sluiten van geinfecteerde littekenbreuken.Nederl. Tijdschr. Geneesk. 1967; 111: 972
- The tensile strength of wounds and factors that influence it.Surg. Gynec. Obstet. 1969; 129: 819
Article info
Publication history
Received in revised form:
May 9,
1970
Received:
January 16,
1970
Identification
Copyright
© 1971 Published by Elsevier Inc.
