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Prevention of Abdominal Wall Hernias

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Abstract

Incisional hernias continue to be a major complication of abdominal wall surgery. Their implications are multifactorial, affecting patients’ quality of life, increasing costs to the patients and healthcare facilities, and increasing patient morbidity with the need to undergo another surgical procedure. A major effort is underway to better understand factors affecting incisional hernia formation and the surgeon’s role in helping to prevent their occurrence. Although many risk factors related to the development of incisional hernias are non-modifiable, there are several ways a surgeon can have impact including choice of incision and closure techniques. In this chapter, we review the many factors contributing to incisional hernia formation and suggest prevention strategies specifically related to laparotomy closure techniques and the use of prophylactic mesh augmentation. It is paramount that surgeons operating on the abdominal wall are familiar with current strategies and evidence-based techniques for closure if we are to have an impact on the formation of incisional hernias.

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Acknowledgments

No funding was received for this work.

Dr. Hope’s disclosures (Not directly related to the current work): CR Bard: honorarium, speaking, research support; WL Gore: research support, speaking; Lifecell: consulting; Intuitive: speaking, consulting.

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Parikh, R.S., Hope, W.W. (2019). Prevention of Abdominal Wall Hernias. In: Davis, Jr., S., Dakin, G., Bates, A. (eds) The SAGES Manual of Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-78411-3_45

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