SURGERY


usually given an inadequate surgical corset to manage their condition, and often live their lives in misery and pain.


Supporting for other centres It is important to get the basics right. For example, knowing how to perform a good Rives-Stoppa dissection (where the mesh is placed behind the rectus muscle and above the peritoneum) with recognition of nerves, vessels, and fat planes, is critical for any surgeon pursuing complex hernia repair as a speciality. A good Rives-Stoppa repair is the bastion of any AWR surgery. Being passionate about the right approach to hernia treatment means the AWR team at Whiston is keen to share knowledge, and help others create their own centres of excellence.


*The author would like to thank contributors Michael Scott, consultant general surgeon and Christian West, consultant plastic surgeon, from The Institute of Abdominal Wall Reconstruction Surgery (TIARS) based at Whiston Hospital, Merseyside, for their help and guidance with this article.


References 1 https://gettingitrightfirsttime.co.uk/wp-content/ uploads/2017/07/GIRFT-GeneralSurgeryReport- Aug17v1.pdf.p11


2 Finan KR, Vick CC, Kiefe CI, et al. Predictors of wound infection in ventral hernia repair. Am J Surg. 2005;190:676–681.


3 Møller AM, Villebro N, Pedersen T, et al. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet. 2002;359:114–117.


4 Sorensen LT, Karlsmark T, Gottrup F. Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg. 2003;238:1–5.


5 Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault DD, Chelala E, et al. Classification of primary and incisional abdominal wall hernias. Hernia. (2009) 13:407–14. 10.1007/ s10029-009-0518-x


6 Tedelin S, et al. Anti-inflammatory properties of the short-chain fatty acids acetate and propionate: a study with relevance to inflammatory bowel disease. World J Gastroenterol 2007; 13:2826–2832. Preclinical study. Results may not correlate to performance in humans.


7 Nguyen PT, Asarias JR, Pierce LM. Influence of a new monofilament polyester mesh on inflammation and matrix remodeling. J Invest Surg 2012; 25: 330


8 Bryan N, Ahswin H, Smart NJ, Bayon Y, Hunt JA. In vitro activation of human leukocytes in response to contact with synthetic hernia meshes. Clin Biochem 2012; 45: 672


9 Aydinuraz K, Agalar C, Agalar F, Ceken S, Buruyurek N, Voral T. In vitro S. epidermidis and S. aureus adherence to composite and


AZ_Erbe_VIO_3_210x297_0217.indd 1 AUGUST 2021 Electrosurgery


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lightweight polypropylene grafts. J Surg Res 2009; 157: e79.


10 Amid PK, Shulman AG, Lichtenstein IL, Hakaha M. Biomaterials for Abdominal Wall Hernia Surgery and Principles of their Applications. Langenbecks Archive Chir. 1994; 379(3): 168-71.


11 Klinge U, Junge B, Spellerberg B, Piroth C, Klosterhalfen B, Schumpelick V. Do multifilament alloplastic meshes increase the infection rate?


Rachel Harding CSJ


Rachel Harding works as a communications and medical writer for BD (Becton Dickinson). She has more than 20 years’ experience in communications, having worked as a journalist, a copywriter and, in the defence sector, as a media relations manager.


Analysis of the polymeric surface, the bacterial adherence, and the in vivo consequences in a rat model. J Biomed Mater Res (Appl Biomater) 2002;


12 Tedelin S, et al. Anti-inflammatory properties of the short-chain fatty acids acetate and propionate: a study with relevance to inflammatory bowel disease. World J Gastroenterol 2007; 13:2826– 2832. Preclinical study. Results may not correlate to performance in humans.


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