The Surgical clinics of North America
-
Inguinal hernias are common, with a lifetime risk of 27% in men and 3% in women. Inguinal hernia repair is one of the most common operations in general surgery. ⋯ Inguinal hernia repairs have morbidity and recurrence rates that are not inconsequential. The search for the gold standard of repair continues.
-
Surg. Clin. North Am. · Feb 2008
ReviewProsthetic material in ventral hernia repair: how do I choose?
Several factors must be considered in deciding which mesh to use for a ventral hernia repair. Open hernia repairs with no exposure of mesh to viscera can be performed with unprotected synthetic mesh, preferably a "lightweight" option. ⋯ Although no long-term data are available about biologic (acellular collagen scaffold) meshes, these may have good results when used in contaminated or well-drained infected fields, and do best when used according to the principles of a high-quality synthetic mesh repair (wide mesh overlap, frequent fixation points). Evidence is still insufficient to support the use of biologic materials for primary hernia repair.
-
Surg. Clin. North Am. · Dec 2007
ReviewThe role of total pancreatectomy and islet autotransplantation for chronic pancreatitis.
Total pancreatectomy and islet autotransplantation are done for chronic pancreatitis with intractable pain when other treatment measures have failed, allowing insulin secretory capacity to be preserved, minimizing or preventing diabetes, while at the same time removing the root cause of the pain. Since the first case in 1977, several series have been published. ⋯ Islet autotransplantation has been done with partial or total pancreatectomy for benign and premalignant conditions. Islet autotransplantation should be used more widely to preserve beta cell mass in major pancreatic resections.
-
Management of traumatic vascular injury can offer special challenges even to experienced surgeons who are functioning in resource-limited situations. Lessons learned from past conflicts have advanced the practice of vascular trauma surgery on the battlefield and in urban trauma centers. Current conflicts provide a fresh opportunity to examine those recent advancements that have improved surgical capability and as a result have changed the practice of vascular surgery on the modern battlefield. This article provides an overview of the contemporary management of vascular injuries in combat casualties during recent United States military operations.