Talbert J L, Rodgers B M, Moazam F
J Pediatr Surg. 1977 Feb;12(1):63-7. doi: 10.1016/0022-3468(77)90297-4.
The management of 7 children with massive abdominal wall hernias is reviewed, utilizing a technique of stabilizing the defect by insertion of a Teflon mesh prosthesis followed by pneumoperitoneum and staged reduction. Teflon mesh has proven ideally suited for this purpose because of its flexibility, elasticity, and relative nonreactivity, allowing it to be applied directly over the surface of exposed bowel without inducing fistula formation. Although the mesh is securely incorporated into the fascial perimeter of the abdominal wall, a pseudomembrane is formed at the point of contact with the bowel surface which allows subsequent dissection and removal of the prosthesis with relative ease. Having limited the size of the defect by insertion of the mesh, an ideal situation is created for use of pneumoperitoneum to expand the peritoneal cavity and stretch the normal tissues of the abdominal wall, thus facilitating subsequent operative reduction of the ventral hernia. Utilizing this approach, excellent cosmetic and functional results have been achieved in all 7 patients.
本文回顾了7例巨大腹壁疝患儿的治疗情况，采用的技术是先插入聚四氟乙烯网片假体稳定缺损，接着进行气腹和分期还纳。聚四氟乙烯网片因其柔韧性、弹性和相对无反应性，已被证明非常适合此用途，可直接应用于暴露肠管表面而不会导致瘘管形成。尽管网片牢固地整合到腹壁筋膜周边，但在与肠管表面接触点会形成假膜，这使得后续能相对轻松地分离并移除假体。通过插入网片限制了缺损大小，为利用气腹扩大腹腔和拉伸腹壁正常组织创造了理想条件，从而便于后续手术还纳腹疝。采用这种方法，所有7例患者均取得了极佳的美容和功能效果。
