Marcelo A Beltrán1, Karina S Cruces. 1. Department Of Surgery, Hospital De Ovalle, Manuel Antonio Caro 2629, La Serena, IV Region, PO Box 912, La Serena, Chile. Beltran_01@Yahoo.Com
Abstract
BACKGROUND: Few reports have dealt with incisional hernias originating at a McBurney incision after appendectomy. The purpose of the present study was to identify risk factors for development of incisional hernia at a McBurney incision, and to describe our experience with the treatment of this kind of hernia. PATIENTS AND METHODS: We reviewed 4,862 files of patients older than 15 years of age operated on for acute appendicitis. Some 4,523 (93%) of that group were operated on through a McBurney incision, and 34 (0.7%) of them developed incisional hernia. To identify risk factors for development of incisional hernia we used binary logistic regression analysis. RESULTS: The following risk factors were identified: female gender (p = 0.011), diabetes (p < 0.0001), peritonitis, abscess or phlegmon as the cause of the first operation (p = 0.009), wound infection (p = 0.034), seroma (p = 0.023), the use of catgut to suture the aponeurosis (p < 0.0001), and interrupted suture to the aponeurotic layer (p = 0.046). Twenty-two hernias were repaired with Mayo-herniorrhaphy and 12 with a subaponeurotic polypropylene prosthesis. Recurrences developed in 3 patients, none in hernias repaired with prosthesis. CONCLUSIONS: The risk of incisional hernia after a McBurney incision for acute appendicitis was very low; we recommend the repair of this uncommon incisional hernia with current standard tension-free prosthetic techniques.
BACKGROUND: Few reports have dealt with incisional hernias originating at a McBurney incision after appendectomy. The purpose of the present study was to identify risk factors for development of incisional hernia at a McBurney incision, and to describe our experience with the treatment of this kind of hernia. PATIENTS AND METHODS: We reviewed 4,862 files of patients older than 15 years of age operated on for acute appendicitis. Some 4,523 (93%) of that group were operated on through a McBurney incision, and 34 (0.7%) of them developed incisional hernia. To identify risk factors for development of incisional hernia we used binary logistic regression analysis. RESULTS: The following risk factors were identified: female gender (p = 0.011), diabetes (p < 0.0001), peritonitis, abscess or phlegmon as the cause of the first operation (p = 0.009), wound infection (p = 0.034), seroma (p = 0.023), the use of catgut to suture the aponeurosis (p < 0.0001), and interrupted suture to the aponeurotic layer (p = 0.046). Twenty-two hernias were repaired with Mayo-herniorrhaphy and 12 with a subaponeurotic polypropylene prosthesis. Recurrences developed in 3 patients, none in hernias repaired with prosthesis. CONCLUSIONS: The risk of incisional hernia after a McBurney incision for acute appendicitis was very low; we recommend the repair of this uncommon incisional hernia with current standard tension-free prosthetic techniques.
Authors: Jacobus W A Burger; Roland W Luijendijk; Wim C J Hop; Jens A Halm; Emiel G G Verdaasdonk; Johannes Jeekel Journal: Ann Surg Date: 2004-10 Impact factor: 12.969
Authors: Marcelo A Beltran; Pedro E Mendez; Rodrigo E Barrera; Mario A Contreras; Christian S Wilson; Victor J Cortes; Karina S Cruces Journal: Indian J Surg Date: 2009-10-17 Impact factor: 0.656