Incisional Hernia: Early Complication of Abdominal Surgery

Burger, Jacobus W. A.; Lange, Johan F.; Halm, Jens A.; Kleinrensink, Gert-Jan; Jeekel, Hans

doi:10.1007/s00268-005-7929-3

Cited by 121 publications

(88 citation statements)

References 27 publications

(42 reference statements)

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“…In the present study, a RAM distance above 20 mm appeared to be the cut‐off point, although earlier studies2 3 suggested that 12‐mm and 15‐mm separation of the fascial edges or RAM distance represent cut‐off points for risk of incisional hernia formation. These differences may be caused by differences in methodology of radiological examination, although it has been shown15 that a RAM distance of 20 mm at the level of the umbilicus is normal in an unoperated population.…”

Section: Discussioncontrasting

confidence: 63%

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Development of incisional herniation after midline laparotomy

Harlaar

Deerenberg

Dwarkasing³

et al. 2017

BJS Open

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BackgroundIncisional herniation is a common complication after abdominal surgery associated with considerable morbidity. The aim of this study was to determine whether incisional hernia is an early complication, in order to understand better the aetiology of incisional hernia formation.MethodsThis study involved the secondary analysis of a subset of patients included in a large RCT comparing small and large tissue bites (5 mm every 5 mm, or 1 cm every 1 cm) in patients scheduled to undergo elective abdominal surgery by midline laparotomy. The distance between the rectus abdominis muscles (RAM distance) was measured by standardized ultrasound imaging 1 month and 1 year after surgery. The relationship between the 1‐year incidence of incisional hernia and the RAM distance at 1 month was investigated.ResultsSome 219 patients were investigated, 113 in the small‐bites and 106 in the large‐bites group. At 1 month after surgery the RAM distance was smaller for small bites than for large bites (mean(s.d.) 1·90(1·18) versus 2·39(1·34) cm respectively; P = 0·005). At 1 year, patients with incisional hernia had a longer RAM distance at 1 month than those with no incisional hernia (mean(s.d.) 2·43(1·48) versus 2·03(1·19) cm respectively; relative risk 1·14, 95 per cent c.i. 1·03 to 1·26, P = 0·015).ConclusionA RAM distance greater than 2 cm at 1 month after midline laparotomy is associated with incisional hernia. Closure with small bites results in a smaller distance between the muscles.

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Section: Discussioncontrasting

confidence: 63%

“…Several hypotheses have been proposed to explain the development of these hernias1. Surgical technique seems important, and two clinical trials2 3 have suggested that an increased distance between the rectus abdominis muscles (RAM distance) 1 month after surgery predicts later incisional hernia formation.…”

Section: Introductionmentioning

confidence: 99%

Development of incisional herniation after midline laparotomy

Harlaar

Deerenberg

Dwarkasing³

et al. 2017

BJS Open

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“…Only two patients in the NCT group and three patients in the CT group had a follow up <12 months. The mean number of previous abdominal operations was two (range [1][2][3][4][5]. The mean defect size in the NCT group was 8 cm (range [3][4][5][6][7][8][9][10][11] and in the CT group it was 9 cm (range 4-12) with no statistically significant difference between the groups.…”

Section: Resultsmentioning

confidence: 91%

“…Moreover, in patients with gynecological malignancies receiving perioperative systemic chemotherapy, the use of biological mesh has been proposed as a prophylactic measure to prevent PIH [1]. The purpose of this study was to compare the rates of hernia recurrence, seroma formation, and wound infection following PIH repair with a biologic prosthesis in a contaminated field, among patients who received perioperative chemotherapy compared to individuals who did not receive chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Chemotherapy does not adversely impact outcome following post‐incisional hernia repair with biomaterial mesh

Saied

David

LaBarbera

et al. 2015

Journal of Surgical Oncology

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Background: Patients receiving chemotherapy are at increased risk for developing recurrent or post-incisional hernias (PIH). Biological materials are an alternative to synthetic mesh in contaminated fields. The impact of chemotherapy on biomaterial tissue ingrowth and integration has not been well studied. Methods: From 2008 to 2011 patients who underwent PIH repair with biomaterial mesh (Biodesign 1 ) were selected. Patients were divided into two groups: those receiving chemotherapy (CT) and those not receiving chemotherapy (NCT). Results: Forty-five patients were identified, 28 (62%) in the NCT group and 17 (38%) in the CT group. Median follow up for NCT and CT groups were 27 and 17 months, respectively. A total of 9/45 (20%) surgical site infections (SSI) were diagnosed, with 6/28 (21%) in the NCT and 3/17 (18%) in the CT group (P ¼ 0.53). Seroma formation was seen in 5/28 (18%) of NCT patients and 4/17 (23%) in CT group (P ¼ 0.46). Overall hernia recurrence rate was 22%, and the rates of recurrence were similar among the CT 3/17 (18%) and NCT 7/28 (25%) groups (P ¼ 0.42). Conclusion: The use of perioperative chemotherapy did not increase the rate of wound complications following PIH repair with biologic mesh in this group of patients.

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“…Its late appearance is due to a little-known mechanisms, such as changes in connective tissue 5,9 . However, studies with metallic markers at the edges of the sheath of the rectus muscles 20 and with CT by measuring the distance between the inside edges of these three muscles 5 , showed that the process that leads to the formation of HIA starts in the first week after surgery and that its clinical manifestation may take years, contributing to both increased weight, the deterioration of patients' physical status and age. This finding emphasizes the responsibility of the surgeon in its prevention by adequate care in both the abdominal wall closure as the prophylaxis of wound infection.…”

Section: Introductionmentioning

confidence: 99%

Grandes hérnias incisionais

Speranzini¹,

Deutsch

2010

ABCD, arq. bras. cir. dig.

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-Background -The correction of abdominal hernias remains one of the most common surgical procedures since it occurs in about 11% of laparotomies. There are several risk factors. Arise, in general, the first five years after the operation and their management is controversial. Aim -Update the means and methods for surgical repair of giant abdominal hernias. Method -Literature review based on PubMed, Lilacs and Scielo with crossing the keywords "abdominal hernia, prostheses, surgical techniques and complications", and adding its own contribution based on the authors' experience in handling this condition. Conclusion -Even the successful correction with the use of large prostheses, may happen procedure inconvenient, because the abdominal wall does not resume its elasticity and compliance at the normal. For this reason, it is important that the patient be advised of the possibility of their expectations regarding the outcome, both aesthetic and functional, not be achieved.RESUMO -Introdução -A correção de hérnias incisionais abdominais permanece como um dos procedimentos cirúrgicos mais comuns uma vez que ela ocorre em cerca de 11% das laparotomias. Vários são os fatores de risco. Surgem, em geral, nos primeiros cinco anos após a operação e seu manuseio ainda é controverso. Objetivo -Atualizar os meios e métodos empregados para a correção cirúrgica das hérnias abdominais gigantes. Método -Revisão da literatura com base no Pubmed, Scielo e Lilacs com cruzamento dos descritores "hérnia abdominal, próteses, complicações e técnicas cirúrgicas", e adicionando contribuição própria baseada na experiência dos autores no manuseio desta afecção. Conclusão -Mesmo as correções bem sucedidas, com a utilização ou não de grandes próteses, não são os procedimentos isentos de inconvenientes, pois a parede abdominal não retoma a sua elasticidade e complacência normais. Por este motivo, é importante que o paciente seja alertado da possibilidade da sua expectativa em relação ao resultado, tanto estético quanto funcional, não ser alcançada.

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Incisional Hernia: Early Complication of Abdominal Surgery

Cited by 121 publications

References 27 publications

Development of incisional herniation after midline laparotomy

Development of incisional herniation after midline laparotomy

Chemotherapy does not adversely impact outcome following post‐incisional hernia repair with biomaterial mesh

Grandes hérnias incisionais

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