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Background This study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of postoperative surgical site occurrence and risk factors of incisional hernia (IH) development following AWD repair with posterior CS with TAR reinforced by retromuscular mesh. Methods Between June 2014 and April 2018, 202 patients with grade IA primary AWD (Björck's first classification) following midline laparotomies were treated using posterior CS with TAR release reinforced by a retro-muscular mesh in a prospective multicenter cohort study. Results The mean age was 42 ± 10 years, with female predominance (59.9%). The mean time from index surgery (midline laparotomy) to primary AWD was 7 ± 3 days. The mean vertical length of primary AWD was 16 ± 2 cm. The median time from primary AWD occurrence to posterior CS + TAR surgery was 3 ± 1 days. The mean operative time of posterior CS + TAR was 95 ± 12 min. No recurrent AWD occurred. Surgical site infections (SSI), seroma, hematoma, IH, and infected mesh occurred in 7.9%, 12.4%, 2%, 8.9%, and 3%, respectively. Mortality was reported in 2.5%. Old age, male gender, smoking, albumin level Conclusion Posterior CS with TAR reinforced by retro-muscular mesh insertion resulted in no AWD recurrence, low IH rates, and low mortality of 2.5%. Trial registration Clinical trial: NCT05278117.

Introduction: Bowel perforations are rare conditions following blunt abdominal trauma. Initial clinical examination may be not significant due to delayed peritoneal reaction. The optimal line of management of hemodynamically stable patients with suspected blunt bowel injury, such as mesenteric hematoma, bowel wall edema or fat infiltration, or free fluid for suspected perforation is unclear. Patients and methods:This study done in zagazig university surgical emergency unit between May 2016 and February 2018.We had 81 patients with suspected bowel perforation after blunt abdominal trauma. The aim of the study:To assess the outcomes of initial conservative therapy and selective delayed surgery in patients with unclear intestinal perforation versus urgent surgical intervention. Conclusion:The outcome of delayed diagnosis and surgery is not always very bad The rate of missed injuries after early and initial evaluation may be decreased by the use of advanced technology, and the risk of delayed diagnosis will reduced by improvements of intensive care unit

Health is not only determined by biological factor but also by both cultural and social environment. So the social determinants are very important factor of health. The social determinants of health are the conditions in which people are ?born, grow, live, work, age,? and which shape their health status.The main objective of this study wasto know the affecting factors and social determinant factors of health seeking behaviour in the study area and to know the people?s perception regarding health and disease. The researcher used such as interview schedule (face to face interview technique using semi structure questions), case study. In this study the researcher has used the survey method for selection of the respondent. The finding reveals that folk tradition and culture mostly close to the health seeking behaviour of the people. Cultural influence was major factor of health among the people. Culture shapes the people what to do, where to go etc. regarding the illness treatment. Therefore, in the process of health seeking behaviour the people influence from the factor of geography, availability, education, income, poverty, gender disparity, social support and network, we feelings, interaction, taking of decision, social ties, share of information, emotion, togetherness of activity and integration of this whole activity etc.