Classification of Rectus Diastasis—A Proposal by the German Hernia Society (DHG) and the International Endohernia Society (IEHS)

Introduction: Recently, the promising results of new procedures for the treatment of rectus diastasis with concomitant hernias using extraperitoneal mesh placement and anatomical restoration of the linea alba were published. To date, there is no recognized classification of rectus diastasis (RD) with concomitant hernias. This is urgently needed for comparative assessment of new surgical techniques. A working group of the German Hernia Society (DHG) and the International Endohernia Society (IEHS) set itself the task of devising such a classification.Materials and Methods: A systematic search of the available literature was performed up to October 2018 using Medline, PubMed, Scopus, Embase, Springer Link, and the Cochrane Library. A meeting of the working group was held in May 2018 in Hamburg. For the present analysis 30 publications were identified as relevant.Results: In addition to the usual patient- and technique-related influencing factors on the outcome of hernia surgery, a typical means of rectus diastasis classification and diagnosis should be devised. Here the length of the rectus diastasis should be classified in terms of the respective subxiphoidal, epigastric, umbilical, infraumbilical, and suprapubic sectors affected as well as by the width in centimeters, whereby W1 < 3 cm, W2 = 3− ≤ 5 cm, and W3 > 5 cm. Furthermore, gender, the concomitant hernias, previous abdominal surgery, number of pregnancies and multiple births, spontaneous birth or caesarian section, skin condition, diagnostic procedures and preoperative pain rate and localization of pain should be recorded.Conclusion: Such a unique classification is needed for assessment of the treatment results in patients with RD

A randomised, multi-centre, prospective, double blind pilot-study to evaluate safety and efficacy of the non-absorbable Optilene® Mesh Elastic versus the partly absorbable Ultrapro® Mesh for incisional hernia repair

<p>Abstract</p> <p>Background</p> <p>Randomised controlled trials with a long term follow-up (3 to 10 years) have demonstrated that mesh repair is superior to suture closure of incisional hernia with lower recurrence rates (5 to 20% versus 20 to 63%). Yet, the ideal size and material of the mesh are not defined. So far, there are few prospective studies that evaluate the influence of the mesh texture on patient's satisfaction, recurrence and complication rate. The aim of this study is to evaluate, if a non-absorbable mesh (Optilene^®Mesh Elastic) will result in better health outcomes compared to a partly absorbable mesh (Ultrapro^®Mesh).</p> <p>Methods/Design</p> <p>In this prospective, randomised, double blind study, eighty patients with incisional hernia after a midline laparotomy will be included. Primary objective of this study is to investigate differences in the physical functioning score from the SF-36 questionnaire 21 days after mesh insertion. Secondary objectives include the evaluation of the patients' daily activity, pain, wound complication and other surgical complications (hematomas, seromas), and safety within six months after intervention.</p> <p>Discussion</p> <p>This study investigates mainly from the patient perspective differences between meshes for treatment of incisional hernias. Whether partly absorbable meshes improve quality of life better than non-absorbable meshes is unclear and therefore, this trial will generate further evidence for a better treatment of patients.</p> <p>Trial registration</p> <p>NCT00646334</p

A gravity-independent powder-based additive manufacturing process tailored for space applications

The future of space exploration missions will rely on technologies increasing their endurance and self-sufficiency, including manufacturing objects on-demand. We propose a process for handling and additively manufacturing powders that functions independently of the gravitational environment and with no restriction on feedstock powder flowability. Based on a specific sequence of boundary loads applied to the granular packing, powder is transported to the printing zone, homogenized and put under compression to increase the density of the final part. The powder deposition process is validated by simulations that show the homogeneity and density of deposition to be insensitive to gravity and cohesion forces within a discrete element method (DEM) model. We further provide an experimental proof of concept of the process by successfully 3D printing parts on-ground and on parabolic flight in weightlessness. Powders exhibiting high and low flowability are used as model feedstock material to demonstrate the versatility of the process, opening the way for additive manufacturing of recycled material

Ressourcenbeschränkte Analyse von Ionenmobilitätsspektren mit dem Raspberry Pi

Die Zusammensetzung der Umgebungs- oder Ausatemluft kann viele Informationen liefern, die z. B. helfen können, eine Erkrankung oder deren Ursache festzustellen. Die Moleküle der in der Luft enthaltenen Substanzen haben jeweils unterschiedliche Größen und Formen, so dass es möglich ist, sie voneinander zu trennen über Ausschläge in einer Luftmessung die Häufigkeit ihres Vorkommens zu bestimmen. Diese Ausschläge werden als Peaks bezeichnet. Ihre Erkennung ist Gegenstand aktueller Forschung. Das Einsatzgebiet solcher Messungen erstreckt sich von medizinischer Überwachung von Patienten im Krankenhaus bis zur Überprüfung der Umgebungsluft bestimmter Gegenden