Fundamentals of incisional hernia prevention

BACKGROUND: The incidence of incisional hernia following surgery is a major economical and clinical burden for healthcare. METHODS: This report reviews and consolidates pertinent literature related to hernia prevention to give surgeons a solid framework on the current perspectives and emerging topic...

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Bibliographic Details
Published in:International journal of abdominal wall and hernia surgery 2018-01, Vol.1 (1), p.32-36
Main Authors: Samuel A Heathcote, Zachary F Williams, W Borden Hooks, William W Hope
Format: Article
Language:English
Subjects:
closure
hernia
incisional laparotomy
prevention
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Summary:BACKGROUND: The incidence of incisional hernia following surgery is a major economical and clinical burden for healthcare. METHODS: This report reviews and consolidates pertinent literature related to hernia prevention to give surgeons a solid framework on the current perspectives and emerging topics related to incisional hernia prevention. RESULTS: Pertinent anatomy and fundamentals of laparotomy closures are reviewed. Recommended closures of laparotomy incisions include the use of monofilament, slowly absorbing suture in a running fashion with a 4:1 suture to wound length ratio using a short stitch technique. The use of prophylactic mesh reduces the rate of incisional and parastomal hernias in high-risk patients. CONCLUSION: The current fundamentals of hernia prevention including pertinent anatomy and surgical techniques for appropriate laparotomy closures should be known to surgeons operating on the abdominal wall. The use of prophylactic mesh to reduce incisional and parastomal hernias has shown promise, and further research is needed to evaluate long-term efficacy.
ISSN:2589-8078
2589-8078
DOI:10.4103/ijawhs.ijawhs_3_18