Abdominal wall dehiscence in emergency midline laparotomy: incidence and risk factors

2020 ◽  
Vol 39 (2) ◽  
pp. 489
Author(s):  
TarekO Hegazy ◽  
SalahS Soliman
Keyword(s):  
Risk Factors ◽  
Abdominal Wall ◽  
Midline Laparotomy

scholarly journals Abdominal Wall Morbidity Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

2017 ◽  
Vol 106 (4) ◽  
pp. 294-298 ◽  
Author(s):  
F. Struller ◽  
I. Koenigsrainer ◽  
P. Horvath ◽  
A. Koenigsrainer ◽  
S. Beckert
Keyword(s):  
Risk Factors ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Pseudomyxoma Peritonei ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Comprehensive Cancer Center ◽  
Midline Laparotomy ◽  
Hernia Formation

Background: Incisional hernia formation has been reported as high as 20% within 1 year following midline laparotomy. Since hyperthermic intraperitoneal chemotherapy is likely to impair wound healing, we sought to investigate the incidence of incisional hernia formation and abdominal wall rupture following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Methods: Consecutive patients with radiographic evidence of peritoneal metastases were scheduled for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at the Comprehensive Cancer Center, University Hospital Tuebingen, Germany. Clinical data were retrospectively analyzed. Results: Between May 2005 and May 2014, 271 patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Within follow-up, 19 (7%) incisional hernias and 11 (4%) abdominal wall ruptures were observed. Age ⩾70 years, cardio-pulmonary comorbidity, the presence of pseudomyxoma peritonei or mesothelioma, and postoperative abdominal wall rupture were detected as risk factors for hernia formation. However, Cox multivariate analysis only confirmed the presence of pseudomyxoma peritonei or mesothelioma and postoperative abdominal wall rupture as independent risk factors. Conclusion: Our data do not suggest that cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is necessarily associated with a higher incidence of incisional hernia formation. However, patients suffering from pseudomyxoma peritonei or mesothelioma and patients with postoperative abdominal wall rupture seem to be at risk for developing incisional herniation.

Predicting adverse neonatal outcomes in fetuses with abdominal wall defects using prenatal risk factors

2009 ◽  
Vol 201 (4) ◽  
pp. 383.e1-383.e6 ◽  
Author(s):  
Sara S. Nicholas ◽  
David M. Stamilio ◽  
Jeffery M. Dicke ◽  
Diana L. Gray ◽  
George A. Macones ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Wall ◽  
Neonatal Outcomes ◽  
Abdominal Wall Defects ◽  
Prenatal Risk ◽  
Prenatal Risk Factors ◽  
Adverse Neonatal Outcomes

Hernias in the Emergency Department

2017 ◽  
Author(s):  
Mary C. Westergaard ◽  
Daniel Berhanu ◽  
Ciara J. Barclay-Buchanan
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Abdominal Wall Hernia ◽  
The United States ◽  
Abdominal Hernia ◽  
Indirect Inguinal Hernia ◽  
Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia. Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

Hernias in the Emergency Department

2018 ◽  
Author(s):  
Mary C. Westergaard ◽  
Daniel Berhanu ◽  
Ciara J. Barclay-Buchanan
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Abdominal Wall Hernia ◽  
The United States ◽  
Abdominal Hernia ◽  
Indirect Inguinal Hernia ◽  
Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia.  Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

scholarly journals A randomized controlled study to compare the efficacy of hughes abdominal repair with conventional abdominal closure-to reduce the incidence of incisional hernias in Indian population

2017 ◽  
Vol 4 (7) ◽  
pp. 2291
Author(s):  
Rajasekaran C. ◽  
Vijaykumar K. ◽  
Arulkumaran M. ◽  
Meera S. S.
Keyword(s):  
Randomized Controlled Trial ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Midline Laparotomy ◽  
Incisional Hernias ◽  
Abdominal Closure ◽  
Randomized Controlled ◽  
Abdominal Repair

Background: Incisional hernia forms the most common delayed morbidity following midline laparotomy surgeries- causing mental trauma to the patient impairing their quality of life and scars the name and fame of the surgeon. So, the need for possible attributes on surgeon’s aspect to prevent the incisional hernia is the need of the hour. We planned a randomized controlled trial to compare two different abdominal closure techniques to reduce the incidence of Incisional hernia following midline laparotomy incisions. We advocated Hughes abdominal repair which includes a series of two horizontal and two vertical mattresses within single suture whereby the tension load of suture is distributed both along and across the suture line.Methods: 1:1 Randomized controlled trial in which the patient is blinded and obviously operating surgeon is non-blinded. Evaluating examiner and radiologist are blinded.100 patients who underwent emergency and elective midline laparotomies were enrolled in the study and intra-operatively randomized into two groups in 1:1 pattern. Ethical clearance obtained from the Institutional ethical committee. The primary outcome measure is the incidence of burst abdomen at the end of 15 days by the evaluating surgeon (non-operated surgeon who is blinded). The secondary outcome is the incidence of incisional hernia at the end of one year-evaluated by detailed clinical examination with radiological proof using CT abdomen.Results: The incidence of incisional hernia is significantly low in Hughes abdominal repair than conventional abdominal closure.Conclusions: Hughes abdominal wall closure is superior to conventional closure in both emergency and elective laparotomy cases, in prevention of wound dehiscence and Incisional hernias later. Present study encourages us that Hughes abdominal wall repair is comparable to mesh repairs. This study needs to be continued further to a vast sample size to perfectly assess the statistical significance.

scholarly journals Abdominal Wall Injuries at the Elite Level in Australian Male Professional Cricketers

2015 ◽  
Vol 49 (4) ◽  
pp. 155-158 ◽  
Author(s):  
David Humphries ◽  
John Orchard ◽  
Alex Kountouris
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Abdominal Wall ◽  
Data Extraction ◽  
Statistical Significance ◽  
Significant Risk ◽  
Oblique Muscle ◽  
Minimal Risk ◽  
Risk Increase ◽  
Elite Level

ABSTRACT Background Injuries to the abdominal wall, particularly muscular injuries, are relatively common in professional cricketers. The Cricket Australia injury database holds data on these injuries over a 20 years span. Methods This study is a combination of (1) a descriptive outline of the parameters associated with side strains and abdominal wall injuries in elite male cricketers, based on deidentified data extraction from the Cricket Australia database from 1995 to 1996 and 2014 to 2015; (2) multivariate regression analysis of risk factors for abdominal wall strains, taking into account the risk factors of player position, player age and previous abdominal wall injury history. Results There were 183 injuries recorded over a 20 years period at Australian state or national player level. Significant risk factors in logistic regression analysis were: being a Pace Bowler RR 10.0 (95% CI 3.1—32.1) and being 24 years old or younger RR 3.4 (95% CI 1.7—6.8). Surprisingly, there was only minimal risk increase, not reaching statistical significance, for recent injury in the same season (p = 0.18) and no association at all with past injury in previous season (p = 0.99). Discussion The internal oblique muscle is reported the most commonly injured component of the abdominal wall, the injuries are overwhelmingly sustained by pace bowlers and the peak incidence of the injury is in the early part of the cricket season. Younger fast bowlers are more likely to be injured than older ones. A history of abdominal wall strain in either the recent or distant past does not increase or decrease future risk of strain, which is in contrast to other muscle strains. How to cite this article Humphries D, Orchard J, Kountouris A. Abdominal Wall Injuries at the Elite Level in Australian Male Professional Cricketers. J Postgrad Med Edu Res 2015;49(4): 155-158.

scholarly journals P100 EARLY POSTOPERATIVE WOUND COMPLICATIONS AFTER MIDLINE LAPAROTOMY CLOSURE WITH SMALL BITES TECHNIQUE: EXPERIENCE FROM A TERTIARY REFERRAL CENTRE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Adomas Gudelis ◽  
Gintaras Simutis ◽  
Julius Pacevicius
Keyword(s):  
Abdominal Wall ◽  
Surgical Site Infections ◽  
Wound Dehiscence ◽  
Patient Characteristics ◽  
University Hospital ◽  
Wound Complications ◽  
Tertiary Referral Centre ◽  
Midline Laparotomy ◽  
Group A ◽  
Wound Length

Abstract Aim To analyze the incidence and risk factors of surgical site infections (SSI) and wound dehiscence (WD) after closure of primary midline laparotomies with small-bites (SB) technique. Material and Methods Retrospective analysis using hospital prospective database of all midline abdominal wall closures (AWC) with SB technique performed in a University Hospital between December 2019 and February 2021. To achieve a proper protocol of AWC with SB technique, it is advised to have suture/wound length (SL/WL) – ratio of more than 4:1. Statistical analysis of the incidence of SSI and AWD, comparing the results when the protocol was properly used (A group) or not (B group), was performed. Between groups, no relevant differences were observed for patient characteristics. Results A total of 108 midline laparotomies were included for analysis. 55.5% of patients were male. The mean age was 62.8 years, mean body mass index was 24.3 kg/m2. 78.7% (85/108) were operated electively. SSI and WD have been recorded in 7 (6.5%) and 8 (7,4%) cases respectively. In 65 (60,2%) patients abdominal wall closure after primary laparotomy was achieved with proper protocol (group A). Median SL/WL in A and B group was 4.57 and 3.43 respectively. The rate of WD in A group (n = 1, 1,5%) was significantly (P=.006) lower than in B group (n = 7, 16,3%). Incidence of SSI was 7,7% (n = 5, A group) vs. 4,7% (n = 2; B group) (P=.420). Conclusions Using a proper AWC protocol has been effective to prevent WD in midline laparotomy.

Gastroschisis Is Associated With Placental Delayed Villous Maturation

2019 ◽  
Vol 23 (3) ◽  
pp. 197-203
Author(s):  
Brittany Ruschkowski ◽  
Anthea Lafreniere ◽  
Dina El Demellawy ◽  
David Grynspan
Keyword(s):  
Risk Factors ◽  
Abdominal Wall ◽  
Maternal Age ◽  
Congenital Abnormality ◽  
Abdominal Wall Defect ◽  
Control Group ◽  
Control Groups ◽  
Wall Defect ◽  
Previous Diagnosis ◽  
Kappa Agreement

Gastroschisis is a congenital abnormality characterized by visceral herniation through an abdominal wall defect. While the cause of gastroschisis is unknown, it has been linked to risk factors including young maternal age, smoking, and alcohol use during pregnancy. To date, the only established placental correlate is amniocyte vacuolization. Based on our clinical experience, we hypothesized that delayed villous maturation (DVM) is also associated with gastroschisis. We conducted a retrospective slide review of 23 placentas of neonates with gastroschisis. Additionally, we selected 2 control groups of placentas: 1 with a previous diagnosis of DVM and 1 with normal villous morphology. All placentas were randomized and reviewed by 2 perinatal pathologists, who were blinded to the group; DVM and amniocyte vacuolization were assessed. Gastroschisis was associated with increased placental DVM in 65.2% of cases (vs 13.6% of controls; P = .0007) and increased amniocyte vacuolization in 52.2% of cases (vs 9.1% of controls; P = .003) compared to the control group. Based on the normal and DVM groups, kappa agreement between current slide review and initial pathology diagnosis was 0.419, indicating moderate agreement. Our study shows that gastroschisis is associated with placental DVM. This association may be due to (1) a common upstream factor contributing to both gastroschisis and DVM or (2) DVM may be a consequence of the altered placental and amniotic environment in the context of gastroschisis.

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