Incisional Herniation Induces Decreased Abdominal Wall Compliance via Oblique Muscle Atrophy and Fibrosis

DuBay, Derek A.; Choi, Winston; Urbanchek, Melanie G.; Xue, Wei; Adamson, Belinda; Dennis, Robert G.; Kuzon, William M.; Franz, Michael

doi:10.1097/01.sla.0000251267.11012.85

Cited by 124 publications

(82 citation statements)

References 22 publications

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“…An other problem mentioned in the literatureinvolving the natural courseoflarge hernias is the atrophic change of the abdominal muscles (28,29). This is the result of inactivity due to loss of the insertion of the oblique and transverse abdominal muscles to the linea alba combined with the evisceration of abdominal contents.…”

Section: Abdominal Wall Fibrosismentioning

confidence: 99%

Natural Course of Incisional Hernia and Indications for Repair

et al. 2007

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Background: Incisional hernias and incisional hernia repair can be asignificant challenge for both surgeon and patient. Despite the growing amount of literature describingvarious methodso fs urgicalt echniques,l ittle has been published the natural course of an incisional hernia and regarding indications for incisional hernia repair.Methods: An internetd atabase search was performed to identify articles describing symptoms presented by patients and indications for incisional hernia repair.Results: Va rious symptoms and indications regarding incisionalhernia repair and the natural course of an incisional hernia are mentioned in the literature. Nevertheless, published data accurately describing these symptoms and indications are rare.Conclusion: Ap rospective trial monitoringi ncisional hernias as well as comparing conservative treatment with repair should be performed.

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Section: Abdominal Wall Fibrosismentioning

confidence: 99%

Natural Course of Incisional Hernia and Indications for Repair

et al. 2007

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“…• Umbilical hernia repair [145,146] • Muscle contractions (pain) [93] • Body builders (six-pack) [115] • Interstitial and anasarc oedema (skin, abdominal wall) • Abdominal burn eschars (circular) [97,98,147] • Thoracic burn eschars (circular) • Tight closure after abdominal surgery • Abdominal Velcro belt or adhesive drapes [148] • Prone positioning [103] • HOB > 45° [102] • Pneumoperitoneum • Pneumatic anti-shock garments • Abdominal wall bleeding • Rectus sheath haematoma [149] • Correction of large hernias • Gastroschisis • Omphalocoele • Mechanical ventilation (positive pressure) [65] • Fighting with the ventilator • Use of accessory muscles • Use of positive end expiratory pressure (PEEP) [66] • Presence of auto-PEEP (tension pneumothorax) • COPD emphysema (diaphragm flattening)…”

Section: Related To Abdominal Wall and Diaphragmmentioning

confidence: 99%

The role of abdominal compliance, the neglected parameter in critically ill patients — a consensus review of 16. Part 2: measurement techniques and management recommendations

Malbrain¹,

Laet²,

Waele³

et al. 2014

Anaesthesiol Intensive Ther

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The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (C ab ) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low C ab . However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and C ab and how certain conditions may affect the results. This review will give a concise overview of the different methods to

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“…Postoperative wound dehiscence rates range between 0.024% to 11% and different factors are defined in etiology (16)(17)(18)(19)(20). One of the important reasons for these differences is inclusion of patients with appendectomy and inguinal hernia repair in large series resulting in a heterogenous group of patients.…”

Section: Discussionmentioning

confidence: 99%

A prospective evaluation of the risk factors for wound dehiscence and incisional hernia development

Yılmaz

Akıncı

Doğan

et al. 2013

UCD

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Objective: Post-laparotomy wound dehiscence, evantration and evisceration are important complications leading to an increase in both morbidity and mortality. Incisional hernias are frequently observed following abdominal surgeries and their occurrence is related to various local and systemic factors. This study aims to analyze the factors affecting wound healing by investigating the parameters that may cause wound dehiscence, incisional hernia, sinus formation and chronic incisional pain. Material and Methods:The records of 265 patients who underwent major abdominal surgery were analyzed. The data on patient characteristics, medication, surgical procedure type, type of suture and surgical instruments used and complications were recorded. The patients were followed up with respect to sinus formation, incisional hernia occurrence and presence of chronic incision pain. Statistical analysis was performed using SPSS 10.00 program. The groups were compared via chi-square tests. Significance was determined as p<0.05. Multi-variate analysis was done by forward logistic regression analysis.Results: 115 (43.4%) patients were female and 150 (56.6%) were male. Ninety-four (35.5%) patients were under 50 years old and 171 (64.5%) were older than 50 years. The median follow-up period was 28 months (0-48). Factors affecting wound dehiscence were found to be; creation of an ostomy (p=0.002), postoperative pulmonary problems (p=0.001) and wound infection (p=0.001). Factors leading to incisional hernia were; incision type (p=0.002), formation of an ostomy (p=0.002), postoperative bowel obstruction (p=0.027), postoperative pulmonary problems (p=0.017) and wound infection (p=0.011). Conclusion:Awareness of the factors causing wound dehiscence and incisional hernia in abdominal surgery, means of intervention to the risk factors and taking relevant measures may prevent complications. Surgical complications that occur in the postoperative period are especially related to wound healing problems.Key Words: Abdominal surgery, wound dehiscence, incisional hernia, sinus formation, chronic incisional pain INTRODUCTIONWound dehiscence after laparotomy can manifest with different presentations varying from simple skin detachment to evisceration and eventration, leading to an increase in surgical mortality and morbidity, as well as increase in length of hospital stay and loss of work force.Anterior abdominal wall incision hernia that can be seen in the long term is also one of the common surgical complications. Known as postoperative hernia or incisional hernia, it is thought to result from insufficient closure of the fascia and/or poor healing. Factors causing chronic or prolonged postoperative intra-abdominal pressure increase and those affecting wound healing contribute to its development. The incidence of incisional hernias vary from 2% to 20% in different sources, and in addition to pain and impairment in quality of life it may also cause significant complications (1, 2). It has been reported that incarceration may occur in a rate of 15%, ...

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Incisional Herniation Induces Decreased Abdominal Wall Compliance via Oblique Muscle Atrophy and Fibrosis

Cited by 124 publications

References 22 publications

Natural Course of Incisional Hernia and Indications for Repair

Natural Course of Incisional Hernia and Indications for Repair

The role of abdominal compliance, the neglected parameter in critically ill patients — a consensus review of 16. Part 2: measurement techniques and management recommendations

A prospective evaluation of the risk factors for wound dehiscence and incisional hernia development

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