Rate of development of incisional hernia 1 year after urgent midline laparotomy

Saleem, Abd-El-Aal A; Abdallah, Hassan A; Raheem, Osama A Abdul; Yousef, Mohamed

doi:10.4103/1687-1693.192653

Cited by 4 publications

(8 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly in group B most patients belonged to age group (41-50 years) followed by age group (21-30 years). Similar observations were made by Saleem AA et al (2016) 8 who found mean age of 39.14 years in group A patients and 29.83 years in group B which is comparable with our study.…”

Section: Incidence Of Incisional Hernia On Follow Upsupporting

confidence: 94%

“…In our study, overall incidence of incisional hernia after midline laparotomy was 8.3% at 6 months and 12.5% at one year follow up for all the studied patients. Our observations are comparable and supported by the study conducted by Saleem AA et al (2016) 8 in their study of 160 patients. Incidence of incisional hernia in their study was 7.5% at 6 months and 17.5% at one year follow up.…”

Section: Incidence Of Incisional Hernia On Follow Upsupporting

confidence: 93%

“…While as out of the 60 patients of Group B, 45 patients (75%) were males and 15 (25%) patients were females. Our observations are supported by Saleem AA et al (2016) 8 his study in which they found that 64 males and 16 females among 80 patients in septic peritonitis whereas 60 males and 20 females among 80 patients in haemoperitoneum.…”

Section: Incidence Of Incisional Hernia On Follow Upsupporting

confidence: 89%

See 2 more Smart Citations

Short Term Incidence of Incisional Hernia after Emergency Midline Laparotomy

Mir¹,

Akram²,

Gilkar³

et al. 2020

jebmh

View full text Add to dashboard Cite

BACKGROUND Incisional hernia is defined by The European Hernia Society as "any abdominal wall gap with or without a bulge in the area of postoperative scar perceptible or palpable by clinical examination or imaging". Incisional hernia is the most frequent postoperative complication following general surgery. The cumulative incidence has remained constant despite several attempts to improve laparotomy closure. In addition to the surgical closure technique, individual biological and patient dependent risk factors play a key role. METHODS The present observational study was conducted in the Postgraduate Department of General Surgery, Government Medical College, Srinagar, at SMHS Hospital from August 2017 to March 2019 and included 120 patients. All patients were operated upon through a midline incision. The patients were divided into two groups. Group A included those patients who had peritonitis and Group B included those patients who had haemoperitoneum. RESULTS In our study it was found that wound infection developed in 19 patients in group A and 8 patients in group B. 11 patients in group A and 5 patients in group B developed wound hematoma. Wound dehiscence occurred in 5 patients in group A and 2 patients in group B. Re-exploration were needed in 1 patient in group A and 2 patients in Group B. Abdominal distention developed in 15 patients in group A and 9 patients in group B. Chest infection developed in 21 patients in group A and 11 patients in group B. At 1-year post-operative follow up, it was found that there was significant increase in incidence of incisional hernia in group A, i.e. 16.66% (10 patients) as compared to group B, i.e. 8.3% (5 patients) with p value of 0.025. CONCLUSIONS Midline laparotomy incision remains the best incision to assess and access the peritoneal cavity for emergency midline laparotomy with regard to septic or haemorrhagic peritonitis (generalized). Comorbidities increase the risk of developing incisional hernia, more so, in septic peritonitis than haemorrhagic peritonitis.

show abstract

Section: Incidence Of Incisional Hernia On Follow Upsupporting

confidence: 94%

Section: Incidence Of Incisional Hernia On Follow Upsupporting

confidence: 93%

Section: Incidence Of Incisional Hernia On Follow Upsupporting

confidence: 89%

See 1 more Smart Citation

Short Term Incidence of Incisional Hernia after Emergency Midline Laparotomy

Mir¹,

Akram²,

Gilkar³

et al. 2020

jebmh

View full text Add to dashboard Cite

show abstract

“…However, these studies have focused solely on elective patients. As much elective surgery has moved towards minimally invasive approaches, the majority of laparotomies are now performed in the emergency setting, which is associated with high rates of IH [8,9]. Furthermore, the European Hernia Society has recently suggested that non-midline incisions should be used to reduce the risk of incisional hernia [10].…”

Section: Introductionmentioning

confidence: 99%

Is there a role for prophylactic mesh in abdominal wall closure after emergency laparotomy? A systematic review and meta-analysis

Burns

Heywood

Challand

et al. 2019

Hernia

View full text Add to dashboard Cite

Background Incisional hernias are a common complication of emergency laparotomy and are associated with significant morbidity. Recent studies have found a reduction in incisional hernias when mesh is placed prophylactically during abdominal closure in elective laparotomies. This systematic review will assess the safety and efficacy of prophylactic mesh placement in emergency laparotomy. Methods A systematic review was performed according to the PROSPERO registered protocol (CRD42018109283). Papers were dual screened for eligibility, and included when a comparison was made between closure with prophylactic mesh and closure with a standard technique, reported using a comparative design (i.e. case-control, cohort or randomised trial), where the primary outcome was incisional hernia. Bias was assessed using the Cochrane risk of bias in non-randomised studies tool. A meta-analysis of incisional hernia rate was performed to estimate risk ratio using a random effects model (Mantel-Haenszel approach). Results 332 studies were screened for eligibility, 29 full texts were reviewed and 2 non-randomised studies were included. Both studies were biased due to confounding factors, as closure technique was based on patient risk factors for incisional hernia. Both studies found significantly fewer incisional hernias in the mesh groups [3.2% vs 28.6% (p < 0.001) and 5.9% vs 33.3% (p = 0.0001)]. A meta-analysis of incisional hernia risk favoured prophylactic mesh closure [risk ratio 0.15 (95% CI 0.6-0.35, p < 0.001)]. Neither study found an association between mesh and infection or enterocutaneous fistula. Conclusion This review found that there are limited data to assess the effect or safety profile of prophylactic mesh in the emergency laparotomy setting. The current data cannot reliably assess the use of mesh due to confounding factors, and a randomised controlled trial is required to address this important clinical question.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

show abstract

“…The incidence of IH ranges from 16% to 33% after emergency laparotomy. [9][10][11][12][13] A large retrospective study, consisting of 29 739 subjects, reported that IH incidence after an emergency operation was as high as 16%, compared with 2% following elective surgery. 13 Nevertheless, prophylactic mesh efficacy in lowering hernia occurrence in emergency or urgency patients has never been evaluated in any randomised clinical trial (RCT).…”

Section: Introductionmentioning

confidence: 99%

Midline incisional hernia prophylaxis using synthetic mesh in an emergency or urgent gastrointestinal tract surgery: a protocol for multicentre randomised clinical trial

et al. 2021

View full text Add to dashboard Cite

IntroductionBetween 5% and 30% of abdominal incisions eventually result in incisional hernias (IHs) that can lead to severe complications and impaired quality of life. Unfortunately, IH repair is often unsuccessful; therefore, hernia prophylaxis is an important issue. The efficacy of mesh augmentation has been proven for hernia prophylaxis in high-risk patients, but no randomised clinical trial has evaluated prophylactic mesh placement in emergency/urgent gastrointestinal operations.Methods and analysisA multicentre, prospective randomised, open and patient–assessor blinded endpoint design will be conducted. A total of 470 patients will be enrolled and randomly allocated to retrorectus mesh augmentation with lightweight polypropylene mesh or primary suture closure. The primary outcome is IH occurrence within 24 months of follow-up, while other clinical outcomes are secondary endpoints. A cost-effectiveness analysis will be conducted from the societal and provider perspectives.Ethics and disseminationEthics approval was obtained from Ramathibodi Hospital (MURA2020/1478) and Vajira Hospital (COA164/2563). The protocol is on the process of submission to the local ethics committee of the other study sites. Results will be submitted for publication in a peer-reviewed journal.Trial registration numberTCTR20200924002.

show abstract

Rate of development of incisional hernia 1 year after urgent midline laparotomy

Cited by 4 publications

References 1 publication

Short Term Incidence of Incisional Hernia after Emergency Midline Laparotomy

Short Term Incidence of Incisional Hernia after Emergency Midline Laparotomy

Is there a role for prophylactic mesh in abdominal wall closure after emergency laparotomy? A systematic review and meta-analysis

Midline incisional hernia prophylaxis using synthetic mesh in an emergency or urgent gastrointestinal tract surgery: a protocol for multicentre randomised clinical trial

Contact Info

Product

Resources

About