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- Dalenbäck, Jan, 1957, et al.
(författare)
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Long-term follow-up after elective adult umbilical hernia repair: low recurrence rates also after non-mesh repairs.
- 2013
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Ingår i: Hernia : the journal of hernias and abdominal wall surgery. - : Springer Science and Business Media LLC. - 1248-9204. ; 17:4, s. 493-497
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to establish long-term outcome after elective adult umbilical hernia (AUH) repair. METHODS: Peri- and postoperative data considering all consecutive procedures at our institution during the time span from 1999 to 2009 were retrospectively gathered and followed by a questionnaire and, if needed, a clinical investigation in early 2011. RESULTS: A total of 162 patients (female/male 35%/65%) were operated, and 144/162 (89%) answers were gathered, mean follow-up time 70months; 77% were sutured, non-mesh repairs; 94% of all AUHs were smaller than 3cm; and 49% of the operations were performed under local anaesthesia. No perioperative complications were encountered. Five postoperative complications were encountered, two serious, both after mesh-based repairs. Wound infection rate (SSI) was low, 2/144 (1.4%). 7/144 (4.9%) recurrences were registered, none if mesh-based techniques were used, giving a recurrence rate of 6.3% in suture-based repairs, the difference, however, not statistically significant (p=0.141); 2% reported persistent pain at follow-up, 89% were overall satisfied with the outcome. CONCLUSIONS: AUH repair could be performed with low early and long-term complication rates, with low recurrence rates also after non-mesh repairs. A substantial cohort of patients will unnecessary be implanted with meshes if mesh-reinforced repairs should be used on a routine basis, that is, 16 surplus meshes to prevent one recurrence in the present study. We recommend a tailored approach to AUH repair: suture-based methods with defects smaller than 2cm and mesh-based repairs considered if larger than that.
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| 2. |
- Tarnow, Peter, 1963, et al.
(författare)
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Increased dermal perfusion after skin burn injury by D-myo-inositol-1,2,6-trisphosphate.
- 1996
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Ingår i: Burns : journal of the International Society for Burn Injuries. - 0305-4179. ; 22:5, s. 363-8
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Tidskriftsartikel (refereegranskat)abstract
- Full-thickness burn injury results in a continuous deterioration of blood flow due to vascular sludging, thrombosis formation and oedema leading to irreversible ischaemia and tissue necrosis. D-myo-inositol-1,2,6-trisphosphate (IP3) has previously been shown to reduce burn-induced oedema formation and inflammation involved in the pathophysiology of progressive ischaemia. A full-thickness burn injury (1 cm2) was induced in the abdominal skin of anaesthetized rats using an electrically heated thermoprobe. Blood flow in the experimental area was measured by laser Doppler flowmetry during 6.5 h postburn. The experiments included five groups. Three burned groups were treated intravenously with IP3 and received respectively: a bolus dose of 4 mg/kg followed by a continuous intravenous infusion of 20 mg/kg/h, 8 mg/kg + 40 mg/kg/h or 16 mg/kg + 60 mg/kg/h. One burned and one unburned control group received a corresponding bolus dose and infusion of saline. Results showed a significant inhibition of dermal ischaemia in the burned groups receiving IP3 at all dose intervals as compared to saline-treated burned rats (all P < 0.001). We conclude that IP3 improved local dermal perfusion in burned skin. Probable mechanisms of action could be the vasodilatory and anti-inflammatory properties of the agent.
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| 3. |
- Tarnow, Peter, 1963, et al.
(författare)
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Inhibition of plasma extravasation after burns by D-myo-inositol-1,2,6-trisphosphate using digital image colour analysis.
- 1998
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - 0284-4311. ; 32:2, s. 141-6
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Tidskriftsartikel (refereegranskat)abstract
- D-myo-inositol-1,2,6-triphosphate (1,2,6-IP3) has beneficial effects in experimental, progressive burn-induced ischaemia and oedema. A 1 cm2 full-thickness burn was made in the skin of 20 rats with a hot aluminium rod followed by infusion of 1,2,6-IP3 (60 mg.kg.-1 h-1) or isotonic saline (n = 10 in each group). One hour later Evans blue was injected intravenously. Colour photographs of the area of the burn were taken in a standard manner before the burn and at intervals for three hours afterwards. The photographs were analysed by digital image colour analysis using normalised red-green-blue values. The increase in normalised blue values between 60 and 180 minutes after the burn was significantly reduced in animals treated with 1,2,6-IP3 compared with control animals (p < 0.001). Spectrophotometric analysis of extravasated Evans blue in the skin 180 minutes after the burn showed that it had been significantly inhibited by treatment with 1,2,6-IP3 (p < 0.001). In conclusion, digital image analysis allowed repeated evaluation over time and confirmed previous data about the ability of 1,2,6-IP3 to inhibit extravasation of plasma after burns.
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| 4. |
- Tarnow, Peter, 1963, et al.
(författare)
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Postoperative analgesia by D-myo-inositol-1,2,6-trisphosphate in patients undergoing cholecystectomy.
- 1998
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Ingår i: Anesthesia and analgesia. - 0003-2999. ; 86:1, s. 107-10
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Tidskriftsartikel (refereegranskat)abstract
- D-myo-inositol-1,2,6-trisphosphate (1,2,6-IP3) possesses antiinflammatory properties, such as reduced eicosanoid synthesis and inhibition of inflammation-induced edema. These properties suggest possible analgesic effects. The analgesic effect of 1,2,6-IP3 was evaluated in a double-blind, randomized study in 24 patients undergoing cholecystectomy. Ten patients received 1,2,6-IP3 as an intravenous (i.v.) bolus dose of 240 mg, followed by a continuous i.v. infusion at 90 mg/h for 24 h. The placebo group (n = 14) received corresponding volumes of isotonic saline. Postoperative pain (visual analog pain scale; VAS) and opiate analgesic requirements (ketobemidon) were evaluated during five postoperative days. Results showed significantly reduced pain during the first five postoperative days in patients treated with 1,2,6-IP3, as measured by using a VAS (P < 0.05). The requirements of opioid analgesics were significantly reduced during the first three postoperative days (P < 0.05). No drug-related side effects were observed. Results of the present study demonstrate a potent and long-lasting analgesic effect of 1,2,6-IP3, possibly related to its antiinflammatory properties. Implications: A new antiinflammatory drug under investigation, inositol-1,2,6-trisphosphate, was evaluated as a possible analgesic in a pilot study during the postoperative period in cholecystectomized patients. Results showed significantly lower pain assessment and opioid consumption, which should encourage further studies.
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