For abdominal surgeries involving large incisions, the surgeon decides whether to make a midline (vertical) or transverse (horizontal) incision. When I had a laparotomy (that’s a major abdominal surgery with an incision of around four or five inches), the surgeon recommended a transverse incision because I could “still wear a bikini.” I’ll tell you how that went in a bit. First, a new study compared the two incision types.

The Department of Surgery at Heidelberg University Hospital studied transverse and midline incisions used in abdominal surgery. The study was published in the Annals of Surgery. Here’s the really interesting thing: The study was blind! Patients received a very large dressing (shown in photo) and had no idea whether the incision was horizontal or vertical. Physicians and nursing staff  were also kept in the dark. This was done so that the pain levels could be accurately obtained. Of course, the surgeon knew the incision type, but the surgeons weren’t involved with gathering data for the study.

Study findings: There was no difference in healing process or post-surgical pain among the two incision types. The complication rate was the same with the exception of wound infection, which was higher for transverse incisions. Researchers concluded that there’s a “scientific basis for allowing the surgeon the free choice of incision technique.”

As for me, I may never know if the incision type caused the extreme post-surgical pain and complication of incisional hernia I experienced. However, if I had it to do over, I’d go with the other incision type (midline) just to see if it turned out better. I don’t wear bikinis anyway. . .

(Image via Heidelberg University Hospital) Sorry for the manly photo in the women’s health section! However, it is from the study.

Post from: Blisstree

Which Incision Type for Abdominal Surgery?

One of the most common foot problems in developed countries is the bunion.

A bunion bony bump that forms on the joint at the base of your big toe. This puts pressure on the toe joint and causes pain.  The toe is also forced inwards, towards your other toes, causing crowding.

Although bunions run in families, they are often caused by shoes that are too tight or ill-fitting. And, as the bunion grows, it becomes harder to find well-fitting, comfortable shoes.

To have the bunion removed, a surgery, a bunionectomy, is done. However, although many people who have had the surgery say it was worth it, it is often a painful surgery. The surgeon removes swollen tissue to make room to straighten the toe joint and may fuse the bones in the joint. According to the MayoClinic.com, “Surgery isn’t recommended unless a bunion causes you frequent pain. A bunionectomy — like other types of surgery — is not without risk. Additionally, you may still have pain or you could develop a new bunion in your big toe joint after surgery. Consider trying conservative treatment before having a bunionectomy.”

For those who do have to have surgery, a new medication is entering phase 3 trials and it is looking quite promising in reducing post-bunionectomy pain. The medication, Adlea, is administered straight to the surgical site and – up to now – has shown to provide good pain relief.

You can read more about the study here: Anesiva Commences Phase 3 Clinical Trial Of Adlea(TM) For Reducing Post Surgical Pain Following Bunionectomy.

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Post from: Blisstree

Med may provide pain relief after surgery for common foot problem