If it was suspected that I had this condition would you repair a hernia down the midline? Is it something you question before surgery? Thanks
Answer: Repairing a rectus divarication in someone with Ehlers Danlos syndrome Many thanks for posting your question. The challenge in someone with Ehlers Danlos, is that there is a fundamental problem with the connective tissues. In practice, this means that the stretching and elastic properties of skin and other connective tissues are not normal.This has two implications:1. The result of surgery may not last for as long as expected, as the tissues (in this case on the abdomen) may stretch out again 2. there may be adverse consequences on wound healing (such as delayed healing and infection risks)Whilst this is not something I routinely specifically ask about, I would certainly want someone to tell me if they had this diagnosis (or suspected diagnosis) during a consultation, as it would need further in depth discussion.I hope this helps - good luck
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Answer: Repairing a rectus divarication in someone with Ehlers Danlos syndrome Many thanks for posting your question. The challenge in someone with Ehlers Danlos, is that there is a fundamental problem with the connective tissues. In practice, this means that the stretching and elastic properties of skin and other connective tissues are not normal.This has two implications:1. The result of surgery may not last for as long as expected, as the tissues (in this case on the abdomen) may stretch out again 2. there may be adverse consequences on wound healing (such as delayed healing and infection risks)Whilst this is not something I routinely specifically ask about, I would certainly want someone to tell me if they had this diagnosis (or suspected diagnosis) during a consultation, as it would need further in depth discussion.I hope this helps - good luck
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Answer: Rectus plication with EDS Hi Rachel and thanks for the question. EDS presents difficult challenges since much of the support for a fascial/rectus sheet repair relies on good quality scar tissue which patients with EDS fail to make. generally speaking, with EDS, one should support any fascial repair or rectus plication with a mesh, however this does not guarantee that the fascia will not stretch or bulge post repair at the interface between the mesh and the "normal fascia".In short, I would attempt to correct rectus diastasis and a midline hernia in a patient with EDS with caution and with the patient being informed that there is a chance the procedure may not work and the subsequent scar may not be as good as one would expect in a patient without EDS.I hope this helps answer your question.RegardsMark Hanikeri
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Answer: Rectus plication with EDS Hi Rachel and thanks for the question. EDS presents difficult challenges since much of the support for a fascial/rectus sheet repair relies on good quality scar tissue which patients with EDS fail to make. generally speaking, with EDS, one should support any fascial repair or rectus plication with a mesh, however this does not guarantee that the fascia will not stretch or bulge post repair at the interface between the mesh and the "normal fascia".In short, I would attempt to correct rectus diastasis and a midline hernia in a patient with EDS with caution and with the patient being informed that there is a chance the procedure may not work and the subsequent scar may not be as good as one would expect in a patient without EDS.I hope this helps answer your question.RegardsMark Hanikeri
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