Summary
The aim of this study was to report the incidence of incisional hernias following midline laparotomy incisions after 12 months and after 8 years. 374 patients who underwent midline laparotomy between August 1989 and December 1990 were included. The wounds were closed with a continuous suture and the technique was monitored by the suture length to wound length ratio. The incidence of incisional hernia, defined as a palpable defect in the fascia or a protrusion beyond this level, was monitored at 12 months and after 8 years. Early wound dehiscence occurred in 3 patients (1%) and wound infection in 32 (9%). At the 12-month examination 58 (20%) incisional hernias were detected in 292 patients. After 8 years 142 patients were examined and 5 (3%) hernias were found. All hernias that caused inconvenience or required surgical repair were detected at 12 months follow-up. Most hernias appearing later have probably been overlooked at the first examination.
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References
Ausobsky JR, Evans M, Pollock AV (1985) Does mass closure of midline laparotomies stand the test of time? A random control clinical trial. Ann R Coll Surg Eng 67: 159–161
Blomstedt B, Welin-Berger T (1972) Incisional hernias. A comparison between midline, oblique and transrectal incisions. Acta Chir Scand 138: 275–278
Douglas DM (1952) The healing of aponeurotic incisions. Br J Surg 284: 931–933
Ellis H, Gajraj H, George CD (1983) Incisional hernias: when do they occur? Br J Surg 70: 290–291
Israelsson LA, Jonsson T (1993) Suture length to wound length ratio and healing of midline laparotomy incisions. Br J Surg 80: 1284–1286
Israelsson LA, Jonsson T (1994) Closure of midline laparotomy incisions with polydioxanone and nylon: the importance of suture technique. Br J Surg 81: 1606–1608
Israelsson LA, Jonsson T (1996) Incisional hernia after midline laparotomy: a prospective study. Eur J Surg 162: 125–129
Jenkins TP (1976) The burst abdominal wound: a mechanical approach. Br J Surg 63: 873–876
Krukowski ZH, Cusick EL, Engeset J et al (1987) Polydioxanone or polypropylene for closure of midline abdominal incisions: a prospective comparative clinical trial. Br J Surg 74: 828–830
Lewis RT, Wiegand FM (1989) Natural history of vertical abdominal parietal closure; Prolene versus Dexon. Can J Surg 32: 196–200
Mudge M, Hughes LE (1985) Incisional hernia; a 10 year prospective study of incidence and attitudes. Br J Surg 72: 70–71
Playforth MJ, Sauven PD, Evans M, Pollock AV (1986) The prediction of incisional hernias by radio-opaque markers. Ann R Coll Surg Engl 68: 82–84
Pollock AV, Evans M (1989) Early prediction of late incisional hernias. Br J Surg 76: 953–954
Sahlin S, Ahlberg L, Granström L, Ljungström K-G (1993) Monofilament versus multifilament absorbable sutures for abdominal closure. Br J Surg 80: 322–324
Truswell AS (1985) ABC of nutrition. BMJ 291: 655–657
Urschel JD, Scott PG, Williams HT (1988) Etiology of late developing incisional hernias — the possible role of mechanical stress. Med Hypothesis 25: 31–34
Waaler HT (1984) Height, weight and mortality, the Norwegian experience. Acta Med Scand [Suppl 679]: 1–55
Wissing J, van Vroonhoven ThJ, Schattenkerk ME et al (1987) Fascia closure after midline laparotomy: results of a randomized trial Br J Surg 74: 738–741
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Cengiz, Y., Israelsson, L.A. Incisional hernias in midline incisions: An eight-year follow up. Hernia 2, 175–177 (1998). https://doi.org/10.1007/BF01569142
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DOI: https://doi.org/10.1007/BF01569142