scholarly journals Analysis of Risk Factors for Incisional Hernias and its Management

2018 ◽  
Vol 10 (2) ◽  
pp. 16-20
Author(s):  
S R Paudel ◽  
B R Neupane ◽  
N V Gurung ◽  
A Acharya ◽  
A Chapagain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
City Hospital ◽  
Midline Incision ◽  
Primary Surgery ◽  
Western Regional ◽  
One Year ◽  
Age Range

Introduction: Incisional hernia is a common problem after abdominal surgery. Patients present with pain, swelling and intestinal obstruction. It may be repaired by either anatomical suturing or mesh repair.Methods: It is a prospective observational study conducted in Western Regional Hospital and Fewa City Hospital, Pokhara from 2013 to 2016. A total of consecutive 100 patients admitted in these hospitals during the study period were included.Results: Incisional hernia is more common in females (M : F = 1 : 3.8), and in 30 - 50 years age group (60%). Major risk factors were wound infection (30%), overweight (25%), and postoperative cough (10%). It is found to be more associated with gynecological (65%), than gastrointestinal operations, and more so with lower abdominal midline incision (65%). It is found to occur mostly within one year (60%) of primary surgery than later. Even 24% of the patients had first symptom within six months. Mesh repair (92%) was the preferred standard surgical treatment for incisional hernia.Conclusion: Overweight females of age range between 30 - 50 years with history of gynecological operations by lower abdominal midline incision are more prone to develop incisional hernia. This incidence increases when there is wound infection. Mesh repair is the choice of operation for incisional hernia. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 16-20

scholarly journals Initial Experience of Open Radical Retropubic Prostatecomy With 5 Cases

KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 166-169
Author(s):  
Md Towhid Belal ◽  
Md Mostafizur Rahman ◽  
Tanvir Ahmed Chowdhury ◽  
Md. Shamim Hossain ◽  
Md Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Surgical Margin ◽  
Radical Retropubic Prostatectomy ◽  
Surgical Team ◽  
Midline Incision ◽  
Perioperative Mortality ◽  
Retropubic Prostatectomy ◽  
Surgical Field ◽  
One Year ◽  
Age Range

Background: Radical prostatectomy is the best treatment option for clinically localized prostate cancer. But oncological as well as functional outcomes of this procedure including incontinence and erectile dysfunction are a big challenge for the surgeon. Objectives: This paper has focused on our initial experiences of oncological and functional outcomes of open radical retropubic prostatectomy. Materials and methods: Total five cases underwent open radical retropubic prostatectomy between January'2016 to October' 2017. All patients had clinically organ confined prostatic adenocarcinoma. Open radical retropubic prostatectomy with bilateral pelvic lymph node dissection was done through a lower midline incision. We observed the surgical experiences and assess the oncological and functional outcomes postoperatively. Results: The median age (range) of patients at diagnosis was 63 (56-72) years. The median Gleason sum (range) was 7 (6-9) and mean pretreatment PSA was 16.2±5.4 ng/ml. There was no perioperative mortality and no major complications in immediate postoperative period. Final pathological specimen shows negative surgical margin in all cases but one patient has positive unilateral lymph nodes. One patient achieved continence within 3 months; three patients achieved continence at 6 months, one patient after one year. Two patients had satisfactory erection at 6 months; onepatients are at 9 months, and two patients could not gain erection after one year. Conclusion: Though open radical retropubic prostatectomy is tough procedure due to its difficult access to the surgical field. Oncological and functional outcome is totally depending on the skill of the surgical team. KYAMC Journal Vol. 9, No.-4, January 2019, Page 166-169

scholarly journals HERNIOPLASTY

2009 ◽  
Vol 16 (02) ◽  
pp. 224-227
Author(s):  
MUHAMMAD FAISAL BILALL ◽  
MUHAMMAD AKRAM ◽  
SUMERA KANWAL ◽  
Jawaid Iqbal
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Enterocutaneous Fistula ◽  
Tertiary Care ◽  
Rectus Sheath ◽  
Fistula Formation ◽  
Open Mesh Repair ◽  
Sublay Technique ◽  
Open Mesh

Incisional hernia is a common complication of abdominal surgery and an important source of morbidity. It may be repairedusing open suture, open mesh or laparoscopic mesh techniques. O b j e c t i v e s : To examine the results of open mesh repair using "sublaytechnique" of hernioplasty. Setting: Surgical Unit-I, Department of Surgery at Allied Hospital, a tertiary care teaching hospital affiliated withPunjab Medical College, Faisalabad. Patient & M e t h o d s : Sixty patients (male:16, female:44) were operated for incisional hernia. Openmesh repair was done. Polypropylene mesh was placed over closed posterior rectus sheath layer and over the rectus abdominis, wereavailable. Anterior rectus sheath was closed in front of the implanted mesh. All the patients received injectable third generation cephalosporinfor 48hrs postoperatively. Postoperative recovery in terms of seroma formation, wound infection, intraabdominal adhesions leading tointestinal obstruction, enterocutaneous fistula formation and recurrence were the main factors noted and analyzed statistically. Results:Mean postoperative hospital stay was 03 days. Only one patient developed wound infection. None of the patients developed seromaformation, intestinal obstruction or enterocutaneous fistula. Maximum follow up till this study is 14 months. No recurrence has been reportedso far. C o n c l u s i o n s : Open mesh repair using "sublay technique" does not carry risk of enterocutaneous fistula, carries low risk of seromaformation and wound infection. Proper technique is not associated with recurrence.

Comparison of Post-Operative Complications Between Sublay and Onlay Mesh Repair in Incisional Hernia

2021 ◽  
Vol 15 (12) ◽  
pp. 3384-3386
Author(s):  
Azizullah Khan Sherani ◽  
Saleem Javed ◽  
Muhammad Idrees Achackzai
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Seroma Formation ◽  
Onlay Technique ◽  
Sublay Technique ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Objective: To compare the post-operative complications between sublay and onlay mesh repair in incisional hernia. Materials & Methods: This randomized controlled trial was conducted at Department of Surgery, Sandeman Provincial Hospital Quetta from May 2019 to November 2019. Total 250 patients with incisional hernias for more than 3 months, having age 20-40 years either male or female were selected. Then selected patients were placed randomly into two groups i.e. Group A (Sublay group) & Group B (Onlay group), by using lottery method. Patients were called for follow up 15th day for post-operative complications in term of wound infection and seroma formation. Results: The mean age of patients in group A was 34.73 ± 4.32 years and in group B was 34.51 ± 4.67 years. Out of these 250 patients, 161 (64.40%) were female and 89 (35.60%) were males with female to male ratio of 1.8:1. Wound infection was seen in 07 (5.60%) patients in group A (Sublay technique) and 17 (13.60%) patients in group B (Onlay technique) with p-value of 0.033. Seroma formation was seen in 09 (7.20%) patients in group A (Sublay technique) and 26 (20.80%) patients in group B (Onlay technique) with p-value of 0.002. Conclusion: This study concluded that rate of wound infection and seroma formation is less after sublay mesh repair for incisional hernia as compared to onlay repair. Keywords: Hernia, incisional, onlay, sublay, seroma.

scholarly journals Incisional hernia after surgical correction of abdominal congenital anomalies in infants: a systematic review with meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Laurens D. Eeftinck Schattenkerk ◽  
Gijsbert D. Musters ◽  
David J. Nijssen ◽  
Wouter J. de Jonge ◽  
Ralph de Vries ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Congenital Anomalies ◽  
Meta Analysis ◽  
Primary Surgery ◽  
Life Threatening ◽  
Review Reports ◽  
Recovery Program ◽  
Closure Method ◽  
Bowel Strangulation

AbstractIncisional hernia (IH) in children could result in life-threatening complications, including incarceration and bowel strangulation. The incidence and risk factors of IH in infants are scarcely reported. Since IH-correction may require extensive surgery and a long recovery program, identifying infants and birth defects at risk, may lead to a different approach during the primary surgery. Therefore, the aim of this review is to systematically review the available data on the incidence of IH following surgery for congenital anomalies in infants. All studies describing IH were considered eligible. PubMed and Embase were searched and risk of bias was assessed. Primary outcome was the incidence of IH, secondary outcomes were difference in IH occurrence between disease severity (complex vs simple) and closure method (SILO vs primary closure) in gastroschisis patients. A meta-analysis was performed to pool the reported incidences in total and per congenital anomaly separately. Subgroup analysis within gastroschisis articles was performed. The 50 included studies represent 3140 patients. The pooled proportion of IH was 0.03 (95% CI 0.02–0.05; I2 = 79%, p ≤ 0.01) all anomalies combined. Gastroschisis (GS) reported highest pooled proportion 0.10 (95% CI 0.06–0.17; n = 142/1273; I2 = 86%; p ≤ 0.01). SILO closure (OR 3.09) and simple gastroschisis, i.e. without additional anomalies, (OR 0.18) were of significant influence. This review reports the incidence of IH in infants with different congenital abdominal anomalies, of which gastroschisis reported the highest risk. In GS patients, complex GS and SILO closure are risk factors for IH development.

scholarly journals A comprehensive study on the incidence and management of incisional hernia

2017 ◽  
Vol 4 (7) ◽  
pp. 2303
Author(s):  
Ajay Malviya ◽  
Arvind Patel ◽  
Girish Bhardwaj ◽  
Hitesh P. Bulchandani ◽  
Vivek Saini
Keyword(s):  
Abdominal Surgery ◽  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Predisposing Factor ◽  
Incisional Hernias ◽  
Medical College ◽  
Vertical Incision ◽  
Obesity Hypertension ◽  
Comprehensive Study

Background: Incisional hernia is a frequent complication of abdominal surgery. The reported incidence of incisional hernia following abdominal surgery ranges from 2-20%. It may be caused by flawed operative techniques, by postoperative complications such as wound infection, by increased abdominal wall tension or by a metabolic connective tissue disorder.Methods: The present study was conducted on patients of incisional hernias admitted in various surgical wards of the department of surgery, associated group of hospitals attached to Dr. Sampurnanand Medical College, Jodhpur over a period of 10 years extending from 2005 to 2015. Detailed history and clinical examination of all patients were obtained from the case sheets. Other risk factors like obesity, hypertension, diabetes mellitus and malignant disease were recorded. Routine investigations were also documented. Patients were closely monitored in pre, intra and post-operative periods. The data collected were systemically recorded and statistically analysed.Results: Maximum incidence (67.21%) of incisional hernia seen in 31-60years of age and mean age was 48.54years with twice common in female sex. Abdominal swelling was the commonest (90.57%) presenting symptom. 80% of patients present within 1 year. Of previous surgery, 50% of them were gynaecological. Midline vertical incision (70%) was most notorious to develop in incisional hernia. Wound infection (50%) was major risk factor. Mesh repair (laproscopic 3.68% & open 92%) was the procedure of choice.Conclusions: Incisional hernia is twice common in women than in men with gynaecological procedures mainly caesarean section contributing for half of the cases of incisional hernias. It more frequently develops in vertical midline incision and post-operative wound infection is the most important predisposing factor. Incisional hernia usually appears within 1 year of previous operation. Mesh repair of incisional hernia has of late become popular amongst surgeons.

scholarly journals Epidemiology and etiological diagnosis of infective keratitis in eastern region of Nepal

2015 ◽  
Vol 7 (1) ◽  
pp. 10-15 ◽  
Author(s):  
R P Sitoula ◽  
S K Singh ◽  
V Mahaseth ◽  
A Sharma ◽  
R K Labh
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Ocular Trauma ◽  
Eastern Region ◽  
Corneal Ulceration ◽  
Corneal Scraping ◽  
One Year ◽  
Age Range ◽  
Epidemiological Characteristics ◽  
Preventable Blindness

Objective: This study aimed to determine the epidemiological characteristics and risk factors predisposing to corneal ulceration in patients presenting to Biratnagar Eye Hospital (Nepal). Methods: All patients presenting to Biratnagar Eye Hospital between January 1 and December 31, 2011 with corneal ulceration were retrospectively reviewed. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined and corneal scrapping and cultures were carried out. Results: Over one year period 1644 patients with corneal ulcer were evaluated, out of which 76.6% of patients were in the age range of 30 to 69 years and 65% of patients had presenting visual acuity < 3/60. Ocular trauma was the most common cause of keratitis accounting for 60.3% of corneal ulcer and majority of the patients (40%) presented after 2 weeks of symptoms. Among corneal scraping positive cases 1150 (70%) showed fungus, 73 (4.4%) showed bacteria and 20 (1.2%) showed both bacterial and fungus. Conclusion: Corneal ulcer continues to be one of the leading causes of preventable blindness in this region. Lack of awareness about gravity of this disease, financial constraints and geographic barriers remain the major reasons for delay in seeking proper medical help.

Pathogenese des zerebralen ischämischen Insults: eine interdisziplinäre Studie

VASA ◽  
2001 ◽  
Vol 30 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Elke Ingeborg Becker ◽  
A. Jung ◽  
H. Völler ◽  
K. Wegscheider ◽  
H.-P. Vogel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Diagnostic Procedures ◽  
Transcranial Sonography ◽  
City Hospital ◽  
Acute Therapy ◽  
Disability Scale ◽  
Neurologic Deficits ◽  
One Year

Background: It is essential to understand the pathogenesis of ischemic stroke to ensure rational acute therapy and secondary prevention. We wanted to know the distribution of pathogenesis in patients of a city hospital and the differences in risk factors, neurologic deficits, disability, and delay in clinical admittance. Patients and methods: During a period of one year, 222 patients (mean age 76,6 years; 59% women) with complete acute ischemic stroke were admitted and underwent complete clinical and diagnostic procedures: CCT/MRI; Doppler- and color-coded duplex and transcranial sonography; echocardiography; use of the NINCDS stroke scale and the Oxford disability scale; study of risk factors, and exploration of delay in admittance. Results: The following percentages of etiologies were evident: 31% cardiogenic embolism (60% with atrial fibrillation), 13% microangiopathy, 9% macroangiopathy, 11% cerebellar or brain stem infarction, 18% more than one cause and 18% no cause found. The patients with cardiogenic embolism showed significantly the highest scores on the stroke scale and the disability scale and had the shortest delay in admittance (57% were admitted within 3 hours). Conclusions: In a city hospital, cardiogenic embolism is the main cause of ischemic stroke. These patients suffer significantly the most severe neurologic deficits, dependence, and requirement of daily nursing care. These patients have the shortest delay in clinical admittance and the best chance of benefiting from acute therapy and early secondary prevention.

scholarly journals A COMPARATIVE STUDY BETWEEN THE INCIDENCE OF WOUND INFECTION AND BURST ABDOMEN BETWEEN DELAYED ABSORBABLE (VICRYL) AND MEDICATED VICRYL (VICRYL PLUS) SUTURE MATERIAL IN PATIENTS UNDERGOING MIDLINE INCISION LAPAROTOMY IN ACUTE ABDOMEN CASES IN THE EMERGENC

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Abhishek Jina ◽  
Abhinav Chaudhary ◽  
U C Singh
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Wound Infection ◽  
Acute Abdomen ◽  
Suture Material ◽  
Significant Risk ◽  
Midline Incision ◽  
Burst Abdomen ◽  
Midline Laparotomy ◽  
Vicryl Suture

Midline laparotomy is frequently done in the emergency setting of any hospital and type of suture material used for the fascial closure of the abdominal wall influences the incidence of the postoperative complications. The aim of this study was to compare the efficacy of the medicated Vicryl (Vicryl plus) suture material with plain Vicryl suture material in patients undergoing midline incision laparotomy in acute abdomen cases based on the postoperative complications. In addition, the effect of various risk factors on burst abdomen and wound infection was also evaluated.  Methods: 100 patients who have visited the emergency department of the hospital and underwent midline laparotomy were enrolled in this study. Results: Patients were divided into two groups depending on whether they have an intestinal perforation (group A, n=60) or intestinal obstruction (Group B, n=40). These two groups were further divided into two groups depending on the type of suture material used (plain Vicryl: group A1, B1 and medicated Vicryl: group A2, B2). Both these groups had an equal number of patients. The analysis of the data showed that compared to the non medicated suture material the rate of wound infection is considerably less in the cases of medicated polyglactin suture material. In addition, older age, diabetes, anemia, and malnutrition are the significant risk factor for wound infection (p<0.001s) while Older age, malnutrition, and cough were found to be highly significant risk factors for burst abdomen. Conclusion: The medicated suture material was proved to be more effective in preventing the burst abdomen and postoperative wound infections compared to the plain delayed absorbable Vicryl suture material. Keywords: delayed absorbable Vicryl, medicated Vicryl, burst abdomen, wound infection, a midline laparotomy

scholarly journals A comparative study of various techniques of incisional hernia repair in a tertiary care center at Bikaner (North-West Rajasthan)

2019 ◽  
Vol 6 (8) ◽  
pp. 2909
Author(s):  
Bhal Singh ◽  
Mahender Kumar Jalthania ◽  
Santosh Kumari
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Mesh Repair ◽  
Abdominal Wall Defect ◽  
Care Center ◽  
Tertiary Care ◽  
Suture Repair ◽  
Onlay Mesh ◽  
Sublay Mesh ◽  
Repair Group

Background: Incisional hernia can be defined as an internal abdominal wall defect that develops after a previously closed laparotomy. Aim of present study was to compare open suture repair and mesh repair (onlay and sublay), various factors predisposing to incisional hernia and evaluate complications following surgery for incisional hernias.Methods: A prospective study was conducted in 60 cases of incisional hernia admitted in Department of General Surgery, PBM Hospital Bikaner between October 2017 to September 2018. 20 cases were selected in each group (open anatomical repair, onlay mesh repair and sublay mesh repair). All cases were followed up for 6 months postoperatively.Results: Incisional hernia was found to occur more often in 41-60 years age group (61.67%) and in females. Wound infection (46.67%) after index surgery was most important risk factor followed by obesity. LSCS (30%) was found to be most common index surgery followed by hysterectomy (28.33%). Seroma was most common postoperative complication (5% patient in anatomical repair group, 30% patients in onlay group and 10% patients in sublay group).Only one recurrence (5%) was observed in anatomical repair group over a period of 6 months follow up.Conclusions: Sublay mesh repair is superior to onlay mesh repair and Anatomical suture repair regarding recurrence rate. Local postoperative complications like seroma formation or wound infection were more common in mesh repair surgery than anatomical repair. Among mesh repair these complications were higher in onlay group than sublay repair.

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