The efficacy of absorbable versus non-absorbable fixation in laparoscopic totally extraperitoneal (tep) repair of large inguinal hernias

Summary: Background/objective: Our study aims to compare clinical outcomes of laparoscopic Totally Extra-peritoneal (TEP) repair with mesh fixation in large inguinal hernias using titanium versus absorbable tacks. Methods: This is a case control study of patients who underwent laparoscopic TEP repair with mesh fixation of large inguinal hernias in our institution from 2010 to 2015. In all patients a standard 10 × 15 cm large-pore polypropylene mesh was used and a standardized fixation technique was followed. Patient demographics, presentation, defect size as per the European Hernia Society Groin Hernia Classification, post-operative complications and recurrence rates were collected and analysed. Results: 20 patients had mesh fixation with titanium tackers (Group TT) were compared with 37 patients who had mesh fixation with absorbable tacks (Group AT). Mean age was 57.00 (±13.78) in Group TT and 49.00 (±17.15) in Group AT. All patients were males. The median defect size was L3M2 in Group TT and L2M2 in Group AT. All patients were followed up for a mean period of 24 months (range: 1–48 months). Post-operatively, one patient in Group AT developed chronic pain. One Group TT patient and four Group AT patients developed seromas, which were treated conservatively. There were no recurrences in Group TT, while one Group AT patient developed a medial recurrence. Conclusion: Both titanium and absorbable tacks showed similar post-operative complications and pain scores. As such, they both appear safe and feasible for mesh fixation during laparoscopic repair of large inguinal hernias. Keywords: Absorbable fixation, Inguinal hernia, Mesh fixation, TEP repai

Extracranial Internal Carotid Artery Aneurysm in Pregnancy

Isolated extracranial internal carotid artery aneurysms (EICAAs) are rare, accounting for only about .4–4% of all peripheral artery aneurysms. We present a case of an EICAA in a young pregnant patient. To our knowledge, this is the first case being reported of a true EICAA during pregnancy in a multiparous woman. A 25-year-old pregnant patient presented with a pulsatile left neck swelling. Radiological investigations and subsequent surgery during the first trimester confirmed a true saccular left ICA with a maximum diameter of 3.5 cm. She was treated with aneurysm excision and primary anastomosis. She did not have any underlying diseases predisposing to an EICAA. She has been well for 3 years post procedure. It has been postulated that pregnancy could lead to aneurysm development through multiple mechanisms, including hemodynamic, hormonal, and other physiologic changes of pregnancy. Aggressive treatment with surgical intervention is advocated because of the risk of cerebral ischemic complications associated with non-operative treatment, and because satisfactory long-term outcomes can be achieved from surgery. </jats:p

sj-docx-3-ijl-10.1177_15347346241233962 - Supplemental material for A Systematic Review and Classification of Factors Influencing Diabetic Foot Ulcer Treatment Adherence, in Accordance With the WHO Dimensions of Adherence to Long-Term Therapies

Supplemental material, sj-docx-3-ijl-10.1177_15347346241233962 for A Systematic Review and Classification of Factors Influencing Diabetic Foot Ulcer Treatment Adherence, in Accordance With the WHO Dimensions of Adherence to Long-Term Therapies by Gwyneth WY Ng, Keith F Gan, Huiling Liew, Lixia Ge, Gary Ang, Joseph Molina, Yan Sun, Prajwala S Prakash, Keerthi B Harish and Zhiwen Joseph Lo in The International Journal of Lower Extremity Wounds</p

sj-xlsx-2-ijl-10.1177_15347346241233962 - Supplemental material for A Systematic Review and Classification of Factors Influencing Diabetic Foot Ulcer Treatment Adherence, in Accordance With the WHO Dimensions of Adherence to Long-Term Therapies

Supplemental material, sj-xlsx-2-ijl-10.1177_15347346241233962 for A Systematic Review and Classification of Factors Influencing Diabetic Foot Ulcer Treatment Adherence, in Accordance With the WHO Dimensions of Adherence to Long-Term Therapies by Gwyneth WY Ng, Keith F Gan, Huiling Liew, Lixia Ge, Gary Ang, Joseph Molina, Yan Sun, Prajwala S Prakash, Keerthi B Harish and Zhiwen Joseph Lo in The International Journal of Lower Extremity Wounds</p