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High rate of incisional hernia observed after mass closure of burst abdomen

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Abstract

Purpose

This study investigated the long-term development of incisional hernia after implementation of a standardized surgical treatment strategy for burst abdomen in abdominal midline incisions with a continuous mass closure technique.

Methods

The study was a single-center, observational study evaluating all patients treated for burst abdomen between June 2014 and April 2019 with a long-term follow-up in October 2020. In June 2014, a standardized surgical treatment for burst abdomen involving a monofilament, slowly absorbable suture in a continuous mass-closure stitch with large bites of 3 cm and small steps of 5 mm was introduced. The occurrence of incisional hernia was investigated and defined as a radiological-, clinical-, or intraoperative finding of a hernia in the abdominal midline incision at follow-up.

Results

Ninety-four patients suffered from burst abdomen during the study period. Eighty patients were eligible for follow-up. The index surgery prior to burst abdomen was an emergency laparotomy in 78% (62/80) of the patients. Nineteen patients died within the first 30 postoperative days and 61 patients were available for further analysis. The long-term incisional hernia rate was 33% (20/61) with a median follow-up of 17 months (min 4, max 67 months).

Conclusion

Standardized surgery for burst abdomen with a mass-closure technique using slow absorbable running suture results in high rates of long-term incisional hernias, comparable to the hernia rates reported in the literature among this group of patients.

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Funding

This study was performed without any kind of funding.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Surgical Section, Copenhagen University Hospital, 2730, Herlev, Denmark

    T. K. Jensen

  2. Department of Surgery, Center for Surgical Science, Zealand University Hospital, Copenhagen University Hospital, 4600, Koege, Denmark

    I. Gögenur

  3. Department of Surgery, North-Zealand University Hospital, 3400, Hilleroed, Denmark

    M.-B. Tolstrup

Authors
  1. T. K. Jensen
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  2. I. Gögenur
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  3. M.-B. Tolstrup
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by TKJ and M-BT. The first draft of the manuscript was written by TKJ and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to T. K. Jensen.

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Conflict of interest

Thomas Korgaard Jensen, Ismail Gögenur, and Mai-Britt Tolstrup declare that they have no conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Decleration and its later amendments. This study was approved by the Danish Data Protection Agency (HGH-2016-030) and the Danish Patient Safety Authority (31-1521-381), and did not need approval by the National Committee on Health Research Ethics (H-19087492).

Consent to participate

Verbal informed consent was obtained from all participants prior to interviews and examination in this study.

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Jensen, T.K., Gögenur, I. & Tolstrup, MB. High rate of incisional hernia observed after mass closure of burst abdomen. Hernia 26, 1267–1274 (2022). https://doi.org/10.1007/s10029-021-02523-4

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  • DOI: https://doi.org/10.1007/s10029-021-02523-4

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