Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies.

Bucknall, T E; Cox, Peter; Ellis, Harold

doi:10.1136/bmj.284.6320.931

Cited by 479 publications

(292 citation statements)

References 17 publications

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“…First, a reduced wound length has been reported to reduce the risk of wound infection, thereby reducing the risk of fascial dehiscence and incisional hernia. 9,10 The second explanation for the difference may be the fact that with a J-shaped incision the avascular linea alba is not crossed and thus does not need to be reconstructed. Although the midline incision is widely practiced, it is known for its higher frequency of incisional hernia compared to paramedian or transverse abdominal incisions.…”

Section: Discussionmentioning

confidence: 99%

A J-shaped subcostal incision reduces the incidence of abdominal wall complications in liver transplantation

et al. 2008

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A novel J-shaped incision for liver transplantation was introduced in attempt to reduce the wound-related complication rate while maintaining comparable access. Some 58 consecutive patients with the classic Mercedes incision were compared with the following 60 consecutive patients with a J-shaped incision. Nine of 60 patients (15%) with a J-shaped incision were converted to an extensive incision. The duration of surgery did not differ between both groups, and relaparotomy rates were comparable in both groups (45% versus 31%, P ϭ 0.487) whereas the early wound-related morbidity was significantly reduced in the J-shaped incision group (3% versus 19%, P ϭ 0.009), as well as incisional hernia rate (7% versus 24%, P ϭ 0.002, corrected for different length of follow-up). Other factors such as previous surgery, ascites, abdominal drainage, retransplantation, and indications for transplantation did not differ between both groups and were not predictive of woundrelated morbidity or incisional hernia. We therefore conclude that a J-shaped incision should be the incision of choice in liver transplantation. This new, seemingly minor modification reduces wound infections, fascial dehiscence, and incisional hernia.

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Section: Discussionmentioning

confidence: 99%

A J-shaped subcostal incision reduces the incidence of abdominal wall complications in liver transplantation

et al. 2008

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“…reported an increase in hospital expenditures on a patient when a surgical site becomes infected. 16 A systematic review by Daskalakis et al, concluded that all patients with nonperforated appendicitis, preoperative treatment is sufficient whereas the use of postoperative antibiotic treatment is not recommended. 17 Whereas, in case of perforated appendicitis, postoperative broadspectrum antibiotics are recommended.…”

Section: Resultsmentioning

confidence: 99%

A randomized control trial to determine the need for postoperative antibiotics after laparoscopic appendicectomy in nonperforated appendicitis

Kajagar

Jakiyuddin

2018

Int Surg J

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Background: Acute Appendicitis is the most common cause of acute pain in the abdomen. Appropriate use of prophylactic antibiotics prevents the risk of postoperative surgical site infections (SSIs). However, there is no conclusive guideline concerning the duration of antibiotic usage. A single preoperative prophylactic dose has been recommended by many randomized control trials. Hence, the study aimed to determine the need for postoperative antibiotics after laparoscopic appendicectomy for nonperforated appendicitis.Methods: A total of 100 patients with nonperforated appendicitis undergoing laparoscopic appendicectomy divided into two groups. Group A (n=50) patients received single dose of preoperative antibiotic and group B (n=50) patients received preoperative dose, as well as three postoperative doses of antibiotics. Routine investigations including complete blood count, blood urea, serum creatinine; other investigations such as ultrasound of abdomen were also performed. Following laparoscopic appendicectomy, surgical wound was inspected after 48 h, 72 h, and on day 7 to look for any signs of postoperative SSI.Results: The mean age in group A was 30.74±10.69 years compared to 30.72±9.56 years (p=0.757) in group B. All the patients in study presented with right iliac fossa pain. Three patients in group A (6%) and two patients in group B (4%) had grade III SSIs, which were managed conservatively. The difference between both the groups for incidence of SSIs was statistically insignificant (p=1.000).Conclusions: Prophylactic postoperative doses of antibiotics confer no additional benefit over a single preoperative dose in preventing the postoperative SSIs after laparoscopic appendicectomy.

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“…Approximately, 10% of all anterior abdominal wall closures are complicated by incisional hernias [14]. Elderly and obese patients are more prone for incisional hernias.…”

Section: Incisional Herniamentioning

confidence: 99%

Multi detector CT Imaging of Abdominal and Diaphragmatic Hernias: Pictorial Essay

et al. 2012

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Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies.

Cited by 479 publications

References 17 publications

A J-shaped subcostal incision reduces the incidence of abdominal wall complications in liver transplantation

A J-shaped subcostal incision reduces the incidence of abdominal wall complications in liver transplantation

A randomized control trial to determine the need for postoperative antibiotics after laparoscopic appendicectomy in nonperforated appendicitis

Multi detector CT Imaging of Abdominal and Diaphragmatic Hernias: Pictorial Essay

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