Dr. Dumanian

Plastic and Reconstructive Surgery

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There are three side muscles–the external oblique, the internal oblique, and the transversus abdominis.  The most common version of the components release hernia repair cuts the external oblique muscle as it inserts onto the vertical rectus abdominis muscles.  The side muscles become more compliant (stretchy) with the external oblique cut, allowing the rectus abdominis muscles to be brought to the midline for the hernia repair.
 
Immediately after surgery, the external oblique muscle is not attached to anything, and theoretically the abdomen could feel weaker.  However, with the repair of the hernia the abdomen once again can increase its internal pressure.  This new sense of a “core” for the patient is a bigger gain than the loss of the external oblique function.  Most patients feel improved immediately after a components separation hernia repair, despite the pain of surgery.
 
Over time, the external oblique sticks back down to the underlying internal oblique muscle, and regains some of its function.  The two intact muscles hypertrophy or bulk up over time, becoming stronger to compensate for the loss of the external oblique.
 

 

Dr. Dumanian is given credit for the development of TMR used to treat this patient in southern Illinois.

http://www.sj-r.com/article/20140323/NEWS/140329739/

Here is a link to an article about our ongoing randomized clinical trial in controlling pain in the limbs of amputees with TMR nerve transfers.

 

http://www.feinberg.northwestern.edu/news/2014/03/Dumanian_nerve_research.html

Dr. Dumanian will give three lectures at the AWR meeting this coming June.  The first will be entitled “The tissue response to synthetic and biologic materials”.  The second is “Local and free flap reconstruction”.  The third is “Perforator Sparing:  Why not the standard”.  On June 13, he will be on a panel entitled “Stump the Experts”.  Looks to be a lively meeting!

Dr. Dumanian will present a talk on the use of mesh in abdominal wall reconstruction at the 2014 AAPS meeting in Florida.

http://www.thepsf.org/research/achievement-awards/innovation-challenge/current-recipients.htm

study news2

Dr. Dumanian has led an effort to develop a new type of surgical suture for abdominal wall closures.  Called “mesh suture”, the innovative suture design allows the tissues to grow into the suture itself for an improved tissue hold.  Dr. Dumanian’s team will present their findings on experimental rat hernia closures comparing a “mesh suture” with a standard polypropylene suture at the American Hernia Society and the Plastic Surgery Research Council meetings, both in March 2013.

Dr. Dumanian has several presentations at the upcoming microsurgery meeting in Jan 2014.  He will present two abstracts focused on the perceptions and goals of upper extremity amputees along with Dr. Sally Jensen, PhD.  He will also participate on a panel of what is new in abdominal wall (hernia) reconstruction.

We presented a poster on our experience in 24 patients who had recurrent ventral hernias, but who had had a prior bioprosthetic mesh repair.  Most of the patients were repaired successfully with prosthetic mesh.