Emergency repair of complicated abdominal wall hernias: WSES guidelines
- 28 Downloads
In July 2013, the World Society of Emergency Surgery (WSES) held the first Consensus Conference on emergency repair of abdominal wall hernias in adult patients with the intention of producing evidence-based guidelines to assist surgeons in the management of complicated abdominal wall hernias. Guidelines were updated in 2017 in keeping with varying clinical practice: benefits resulting from the increased use of biological prosthesis in the emergency setting were highlighted, as previously published in the World Journal of Emergency Surgery. This executive summary is intended to consolidate knowledge on the emergency management of complicated hernias by providing the broad readership with a practical and concise version of the original guidelines.
This executive manuscript summarizes the WSES guidelines reporting on the emergency management of complicated abdominal wall hernias; statements are highlighted focusing the readers’ attention on the main concepts presented in the original guidelines.
Emergency repair of complicated abdominal hernias remains one of the most common and challenging surgical emergencies worldwide. WSES aims to provide an essential version of the evidence-based guidelines focusing on the timing of intervention, laparoscopic approach, surgical repair following the Centers for Disease Control and Prevention (CDC) wound classification, antimicrobial prophylaxis and anesthesia in the emergency setting.
KeywordsAbdominal hernia Hernia repair Emergency surgery Incarcerated hernia Strangulated hernia Biological mesh
FC conceived the study; AB wrote the first manuscript; BDS revised and summarized the original manuscript; all the authors approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interests for this paper.
Approval from the institutional review board was not required for this study.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, formal consent is not required.
- 6.Tsumura H, Ichikawa T, Hiyama E, Murakami Y, Sueda T (2004) Systemic inflammatory response syndrome (SIRS) as a predictor of strangulated small bowel obstruction. Hepatogastroenterology 51(59):1393–1396Google Scholar
- 12.Deeba S, Purkayastha S, Paraskevas P, Athanasiou T, Darzi A, Zacharakis E (2009) Laparoscopic approach to incarcerated and strangulated inguinal hernias. JSLS J Soc Laparoendosc Surg. 13(3):327–331Google Scholar
- 14.Sajid MS, Ladwa N, Colucci G, Miles WF, Baig MK, Sains P (2013) Diagnostic laparoscopy through deep inguinal ring: a literature-based review on the forgotten approach to visualize the abdominal cavity during emergency and elective groin hernia repair. Surg Laparosc Endosc Percutan Tech 23:251–254. https://doi.org/10.1097/SLE.0b013e31828dacc5 CrossRefGoogle Scholar
- 29.Kelly ME, Behrman SW (2002) The safety and efficacy of prosthetic hernia repair in clean–contaminated and contaminated wounds. Am Surg 68(6):524–528Google Scholar
- 37.Coccolini F, Catena F, Bertuzzo VR, Ercolani G, Pinna A, Ansaloni L (2013) Abdominal wall defect repair with biological prosthesis in transplanted patients: single center retrospective analysis and review of the literature. Updat Surg. 65(3):191–196. https://doi.org/10.1007/s13304-013-0212-5 CrossRefGoogle Scholar
- 44.De Simone B, Catena F, Biondi A et al (2016) Incisional Hernia Repair in Contaminated Surgical fields (I.H.R.C.S.) study using biological prostheses in emergency surgery setting with contaminated hernias: a multicenter prospective observational study. J Peritoneum (and other serosal surfaces). https://doi.org/10.4081/joper.2016.26 Google Scholar
- 47.Roberts DJ, Ball CG, Kirkpatrick AW (2016) Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome. Curr Opin Crit Care 22(2):174–185Google Scholar
- 53.Tsuei BJ, Skinner JC, Bernard AC, Kearney PA, Boulanger BR (2004) The open peritoneal cavity: etiology correlates with the likelihood of fascial closure. Am Surg 70:652–656Google Scholar
- 54.Reimer MW, Yelle JD, Reitsma B, Doumit G, Allen MA, Bell MS (2008) Management of open abdominal wounds with a dynamic fascial closure system. Can J Surg 51(3):209–214Google Scholar
- 55.Boele Van Hensbroek P, Wind J, Dijkgraaf MGW, Busch ORC, Carel Goslings J (2009) Temporary closure of the open abdomen: a systematic review on delayed primary fascial closure in patients with an open abdomen. World J Surg 33(2):199–207. https://doi.org/10.1007/s00268-008-9867-3 CrossRefGoogle Scholar