{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T00:17:47Z","timestamp":1704759467153},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T00:00:00Z","timestamp":1146096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Burst abdomen is a continuing problem for the general surgeon as the incidence of such complication may reach 3% with a mortality rate exceeding 25%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>New technique: A lateral incision is done from inside the abdomen along a line between the costal margin above to the iliac crest below in the area between the mid and anterior axillary line. According to the depth of the incision, the incision may either involve the transversus abdominus and internal oblique muscles (TI incision), or include in addition the external oblique muscle (TIE incision), or it may also involve the Scarpa\u2019s fascia (TIES incision). Such incisions would give an extra length on each side towards medial advancement. Eight patients, 5\u00a0men and 3 women aged 34\u201367 years, with burst abdomen after major gastrointestinal and hepatobiliary surgery failed to close primarily were managed using this technique. Long\u2010term follow\u2010up patients was done for development of complications. Electromyogram (EMG) for the rectus muscle and sensory loss for the abdominal wall were also tested. The distance between the 2 cut edges of the different release incisions was measured clinically (TIES incisions) or using ultrasound device (TI and TIE incisions). Scarpa\u2019s fascia biopsy was taken from 1 patient of the TIE group for histopathological study 6 years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One patient died on the third postoperative day (mortality 12.5%), and 2 patients developed subincisional abscesses (25%). No single case of reburst occurred. Long\u2010term follow\u2010up showed no single case of incisional hernia in the site of the midline surgical incision, but incisional hernia did occur in all the sites of TIES incisions. Incisional hernia did not occur in the TI incision and, more strangely, neither did it occur in any of the TIE incisions. Follow\u2010up of the incisions width showed a significant increase in width of the TIES with time while there was no significant increase in that of the TI or TIE. There was a sensory loss at and below the level of umbilicus in the TIES group. EMG showed evidence of motor affection to the rectus muscle at and below the level of the umbilicus in all groups. Scarpa\u2019s fascia biopsy was taken to try to find an explanation for the absence of incisional hernia in TIE incisions and was found to be 3 times as thick and the type I collagen was replaced by collagen type III.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The new method described is simple, straightforward and tension free, with a comparable mortality and morbidity. The Scarpa\u2019s fascia adaptation and its ability to change have enormous applications in general and reconstructive surgery, but further evaluation of such phenomenon is needed.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0450-x","type":"journal-article","created":{"date-parts":[[2006,5,18]],"date-time":"2006-05-18T09:20:32Z","timestamp":1147944032000},"page":"1063-1073","source":"Crossref","is-referenced-by-count":8,"title":["A New Technique in Closure of Burst Abdomen: TI, TIE and TIES Incisions"],"prefix":"10.1002","volume":"30","author":[{"given":"M. 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