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  1. Article: Suturable Mesh Demonstrates Improved Outcomes over Standard Suture in a Porcine Laparotomy Closure Model.

    Dumanian, Gregory A

    Plastic and reconstructive surgery. Global open

    2021  Volume 9, Issue 10, Page(s) e3879

    Abstract: Background: Laparotomy closures fail due to suture pull-through. I hypothesize that a suturable mesh may limit pull-through via mechanisms of force distribution and fibrous encapsulation of the device filaments.: Methods: Fifteen domestic swine 74 kg ...

    Abstract Background: Laparotomy closures fail due to suture pull-through. I hypothesize that a suturable mesh may limit pull-through via mechanisms of force distribution and fibrous encapsulation of the device filaments.
    Methods: Fifteen domestic swine 74 kg in size were randomly allocated to three groups for laparotomy closure with either size 0 suturable mesh, number 1 suturable mesh, or number 1 polypropylene. All three devices were placed in running fashion with 1-cm bites and 1-cm travels. Primary endpoints were hernia formation at 13 weeks and a semiquantitative analysis of the histological tissue response. Secondary endpoints included adhesions, surgical site occurrence (SSO), and documentation of "loose sutures."
    Results: There were numerically fewer hernias in the number 1 suturable mesh group. Nine of the 10 suturable mesh devices were well encapsulated within the tissues and could not be pulled away, whereas four of the five polypropylene sutures were loose. Adhesions were least for number 1 suturable mesh. Histologically, the suturable mesh implanted devices showed good fibrovascular ingrowth and were judged to be "nonirritants." The soft-tissue response was statistically greater (
    Conclusions: The mechanism by which meshes support closure sites is clearly demonstrated with this model. Suturable mesh has the potential to change surgical algorithms for abdominal wall closure.
    Language English
    Publishing date 2021-10-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000003879
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Discussion: Advantages of a Fixation-Free Technique for Open Retromuscular Ventral Hernia Repair.

    Dumanian, Gregory A

    Plastic and reconstructive surgery

    2020  Volume 146, Issue 4, Page(s) 891–892

    MeSH term(s) Hernia, Ventral/surgery ; Herniorrhaphy ; Humans
    Language English
    Publishing date 2020-09-21
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000007216
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  3. Article ; Online: Discussion: Postoperative Outcomes in Obese Patients That Undergo Ventral Hernia Repair versus Ventral Hernia Repair with Concurrent Panniculectomy.

    Dumanian, Gregory A

    Plastic and reconstructive surgery

    2019  Volume 143, Issue 4, Page(s) 1220–1221

    MeSH term(s) Abdominoplasty ; Hernia, Ventral/surgery ; Herniorrhaphy ; Humans ; Lipectomy ; Obesity/surgery
    Language English
    Publishing date 2019-02-27
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000005472
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  4. Article: Management of Superficial and Deep Peroneal Nerve Neuromas with Targeted Muscle Reinnervation in Nonamputees: Operative Technique and Early Outcomes.

    Moradian, Simon / Taritsa, Iulianna C / Sharma, Sripadh / Mioton, Lauren / Dumanian, Gregory A / Ko, Jason H

    Plastic and reconstructive surgery. Global open

    2024  Volume 12, Issue 4, Page(s) e5742

    Abstract: Background: Targeted muscle reinnervation (TMR), a surgical technique developed by the senior authors that coapts proximal ends of nerves to distal motor nerves of adjacent muscles, has demonstrated efficacy in the treatment and prevention of neuroma ... ...

    Abstract Background: Targeted muscle reinnervation (TMR), a surgical technique developed by the senior authors that coapts proximal ends of nerves to distal motor nerves of adjacent muscles, has demonstrated efficacy in the treatment and prevention of neuroma pain. The objective of this study is to describe the surgical technique for TMR of the superficial peroneal nerve (SPN) and deep peroneal nerve (DPN) in nonamputee patients and provide data on postoperative functional outcomes.
    Methods: A single-institution retrospective chart review was performed between March 2018 and April 2021. Patients were de-identified and included if they were nonamputees receiving TMR for pain in the peroneal nerve distribution. Data extracted included demographic information, symptoms before operation, relevant nerve coaptation, peri-, and postoperative complications, and long-term functional outcomes.
    Results: Of the 19 patients reviewed, 11 patients underwent TMR of the SPN alone: eight had complete resolution of their symptoms; two indicated partial improvement in pain; and one patient had no improvement. Four patients underwent TMR of the DPN alone: two patients had complete resolution of their pain, and two patients had partial improvement with pain. Four patients underwent TMR of both the SPN/DPN: two patients had complete resolution of their symptoms, and two patients were noted to have significant improvement but had persistent pain from prior foot operations. Average follow-up time was 260 days.
    Conclusions: TMR is a successful technique in the management of SPN and DPN neuroma pain. Our technique revealed excellent clinical outcomes, no procedure-specific complications, and improved subjective pain reports.
    Language English
    Publishing date 2024-04-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000005742
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Novel mesh suture may resist bone cutting seen with wire-based sternal closures.

    Bharadwaj, Sandeep N / Raikar, Connor H / Dumanian, Gregory A / Malaisrie, S Christopher

    JTCVS techniques

    2023  Volume 20, Page(s) 130–137

    Abstract: Objective: Sternal dehiscence is frequently associated with wire-based closures cutting through fragile bone, allowing sternal motion, separation, and infection. We investigated whether bone cutting could be limited by using a newly available mesh ... ...

    Abstract Objective: Sternal dehiscence is frequently associated with wire-based closures cutting through fragile bone, allowing sternal motion, separation, and infection. We investigated whether bone cutting could be limited by using a newly available mesh suture with improved force distribution.
    Methods: Five sternal models were closed using 8 interrupted single sternal wires, double sternal wires, braided poly(ethylene terephthalate) sutures, single-wrapped mesh sutures, or double-wrapped mesh sutures. To simulate chest-wall forces, closed sternal models were pulled apart using 1020 N of axial force applied incrementally. Double sternal wire and double-wrapped mesh suture were further compared by closing 3 new models with each material and subjecting these models to cyclic loading cycles, simulating breathing and coughing. Image analysis of needle hole size measured "bone cutting" by each closure material and sternal distraction as a function of force.
    Results: All models exhibited maximal separation at the xiphoid. During axial loading, needle hole size increased 7.2% in the double-wrapped mesh suture model and 9.2% in the double-wire model. Single-wrapped mesh suture, single wires, and braided poly(ethylene terephthalate) extended needle hole size by 6.7%, 47.0%, and 168.3% of original size, respectively. The double-wire model resisted sternal distraction best, separating 0.285 cm at the xiphoid. During cyclic loading, mesh suture exhibited significantly less bone cutting (
    Conclusions: Mesh suture may resist bone cutting seen in sternal wire closure in bone models with comparable distraction to currently used sternal closure methods.
    Language English
    Publishing date 2023-06-20
    Publishing country United States
    Document type Journal Article
    ISSN 2666-2507
    ISSN (online) 2666-2507
    DOI 10.1016/j.xjtc.2023.06.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient.

    Papasotiriou, Sam D / Dumanian, Gregory A / Strong, Scott A / Hanauer, Stephen B

    JGH open : an open access journal of gastroenterology and hepatology

    2023  Volume 7, Issue 11, Page(s) 740–747

    Abstract: Prolonged perineal wound healing following proctocolectomy in patients with inflammatory bowel disease (IBD) is a frustrating result for the medical team and patients who were hoping for improved quality of life. Prolonged healing, which lasts more than ... ...

    Abstract Prolonged perineal wound healing following proctocolectomy in patients with inflammatory bowel disease (IBD) is a frustrating result for the medical team and patients who were hoping for improved quality of life. Prolonged healing, which lasts more than 6 months following proctocolectomy, is termed persistent perineal sinus (PPS) and typically necessitates further surgical management. Healing of the PPS is difficult due to the resulting "dead space" following proctocolectomy, necessitating the need to fill the void with viable tissue in an area with anatomic constraints. Here we provide a narrative review and comprehensively address the incidence, pathogenesis, and clinical and operative management of a PPS in patients with IBD following proctocolectomy. Operative methods discussed include surgical debridement, flap closure of the perineum, omental flap closure, and gracilis muscle transposition. It is necessary to further investigate and establish a gold standard of care for these patients.
    Language English
    Publishing date 2023-10-27
    Publishing country Australia
    Document type Journal Article ; Review
    ISSN 2397-9070
    ISSN (online) 2397-9070
    DOI 10.1002/jgh3.12983
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  7. Article ; Online: Discussion: Concomitant Panniculectomy Affects Wound Morbidity but Not Hernia Recurrence Rates in Abdominal Wall Reconstruction: A Propensity Score Analysis.

    Dumanian, Gregory A

    Plastic and reconstructive surgery

    2017  Volume 140, Issue 6, Page(s) 1274–1276

    Language English
    Publishing date 2017-09-09
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/PRS.0000000000003893
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips.

    Kearney, Aaron M / Dumanian, Gregory A

    Plastic and reconstructive surgery. Global open

    2020  Volume 8, Issue 7, Page(s) e2970

    Abstract: Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically ... ...

    Abstract Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically difficult aspect of these repairs is fixating the abdominal wall to the iliac crest. The senior author has developed a method of repair using 2-cm strips of mesh. In this article, we present a description of 4 patients treated with this technique.
    Methods: We included 4 adult patients who underwent traumatic flank hernia repairs by the senior author. We excluded incisional hernias and patients who received a planar sheet of mesh. Demographics and outcomes collected included length of stay, follow-up time, and complications.
    Results: The average age was 38.5 years. Three hernias were due to motor vehicle collision injuries, and 1 was a crush injury at work. No planar meshes or bone anchors were used. No patients required component separation. There were no instances of surgical site infection, hematoma, or wound breakdown. All repairs were intact at the time of last follow-up (average, 24.3 months; range, 4-48.7 months).
    Conclusions: Traumatic flank hernias are rare injuries that can be difficult to address. Here, we describe a technique of primary repair with mesh strips that distribute the forces of repair across a greater surface area than can be achieved with sutures. Placing drill holes through the iliac crest avoids the cost and complexity of suture anchors.
    Language English
    Publishing date 2020-07-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000002970
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  9. Article ; Online: Fascial Closure: New Surgery Paradigms.

    Dumanian, Gregory A / Moradian, Simon

    Advances in surgery

    2020  Volume 54, Page(s) 215–229

    MeSH term(s) Animals ; Fasciotomy ; Foreign-Body Reaction/etiology ; Herniorrhaphy/methods ; Humans ; Laparotomy/methods ; Surgical Mesh ; Suture Techniques/adverse effects ; Sutures ; Tensile Strength ; Wound Healing
    Language English
    Publishing date 2020-06-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 411889-3
    ISSN 1878-0555 ; 0065-3411
    ISSN (online) 1878-0555
    ISSN 0065-3411
    DOI 10.1016/j.yasu.2020.05.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Surgical Treatment of Abdominal Wall Neuromas.

    Chappell, Ava G / Yang, Christopher S / Dumanian, Gregory A

    Plastic and reconstructive surgery. Global open

    2021  Volume 9, Issue 5, Page(s) e3585

    Abstract: Neuromas are an under-recognized contributor to chronic abdominal pain. Other than after mesh inguinal hernia repair, surgical management of painful abdominal wall neuromas has not been well established in the literature.: Methods: All patients who ... ...

    Abstract Neuromas are an under-recognized contributor to chronic abdominal pain. Other than after mesh inguinal hernia repair, surgical management of painful abdominal wall neuromas has not been well established in the literature.
    Methods: All patients who underwent surgical treatment for painful abdominal wall neuromas by the senior author at Northwestern Memorial Hospital were reviewed. Patients were treated with neuroma excision and allograft nerve reconstruction and/or with targeted muscle reinnervation (TMR). Follow-up pain surveys were issued to assess pain levels, activities of daily living, and pain medication usage.
    Results: Twenty patients met inclusion criteria. Eighteen (90%) patients reported improvement in neuropathic pain postoperatively. Two (10%) patients had TMR following failed nerve allograft reconstruction, which led to complete pain resolution. Twenty-seven nerves were treated surgically, the majority of which were abdominal intercostal (13), followed by ilioinguinal (10), genitofemoral (3), and iliohypogastric (1). Nerve allograft reconstruction was used alone for 18 procedures, in combination with TMR for 2, and TMR was used alone in 8. In all cases of TMR, the freshened nerve ending after neuroma excision was coapted to a motor nerve of the internal oblique. The mean length of follow-up was 18.9 months (SD ±14.5).
    Conclusions: This retrospective review demonstrated that 90% (18) of the patients had significant improvement in abdominal neuroma pain postoperatively. These results may help guide providers toward effective management of abdominal wall neuropathic pain.
    Language English
    Publishing date 2021-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000003585
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