Substantiation of application of «nonrebundant» and «tension-free» principles in hernioabdominoplasty in patients, suffering hernias and ventral deformities

Abstract

Objective. Clinical assessment of combined application of the calculated dermolipectomy with improved hernioabdominoplasty in treatment of patients, suffering hernias and external abdominal deformities, who have excessive tissues of abdominal wall. Materials and methods. The investigation is based on data of paraoperative examinations and own results of surgical treatment of 67 patients with hernias and external abdominal deformities. Rational methods of their operating were substantiated on background of morphometric characteristics, determined in accordance to the ventral deformity dimensions, and percentages of adipose-containing, fibrous-cicatricial and pathological components content. Results. The program unit «Statistica 6.1» was applied for statistical elaboration of the results obtained. Algorithm of quantitative investigations of the ventral tissues excessives, which have had predominantly supraaponeurotic localization, was elaborated for the first time. Preoperatively calculated volumes of preventive dermo- and fibrolipectomies, which were performed together with hernio- and abdominoplasties in accordance to new principle «without excesses of parahernial tissues» in various hernias and venral deformities, have reduced essentially the local complications rate - to 2% (р < 0.05) and improved the indices of quality of life and the patients’ health. Conclusion. Practical application of the «tension-free» and «nonrebundant» principles in operating of hernias constitute the base for further elaborations of reconstructive-plastic interventions and a real component of the problem decision in medico-social and esthetic rehabilitation of certain herniological patients.