T K Jensen1, I Gögenur2, M-B Tolstrup3. 1. Department of Gastroenterology, Surgical Section, Copenhagen University Hospital, 2730, Herlev, Denmark. Thomas.korgaard.jensen@gmail.com. 2. Department of Surgery, Center for Surgical Science, Zealand University Hospital, Copenhagen University Hospital, 4600, Koege, Denmark. 3. Department of Surgery, North-Zealand University Hospital, 3400, Hilleroed, Denmark.
Abstract
PURPOSE: This study investigated the long-term development of incisional hernia after implementation of a standardized surgical treatment strategy for burst abdomen in abdominal midline incisions with a continuous mass closure technique. METHODS: The study was a single-center, observational study evaluating all patients treated for burst abdomen between June 2014 and April 2019 with a long-term follow-up in October 2020. In June 2014, a standardized surgical treatment for burst abdomen involving a monofilament, slowly absorbable suture in a continuous mass-closure stitch with large bites of 3 cm and small steps of 5 mm was introduced. The occurrence of incisional hernia was investigated and defined as a radiological-, clinical-, or intraoperative finding of a hernia in the abdominal midline incision at follow-up. RESULTS: Ninety-four patients suffered from burst abdomen during the study period. Eighty patients were eligible for follow-up. The index surgery prior to burst abdomen was an emergency laparotomy in 78% (62/80) of the patients. Nineteen patients died within the first 30 postoperative days and 61 patients were available for further analysis. The long-term incisional hernia rate was 33% (20/61) with a median follow-up of 17 months (min 4, max 67 months). CONCLUSION: Standardized surgery for burst abdomen with a mass-closure technique using slow absorbable running suture results in high rates of long-term incisional hernias, comparable to the hernia rates reported in the literature among this group of patients.
PURPOSE: This study investigated the long-term development of incisional hernia after implementation of a standardized surgical treatment strategy for burst abdomen in abdominal midline incisions with a continuous mass closure technique. METHODS: The study was a single-center, observational study evaluating all patients treated for burst abdomen between June 2014 and April 2019 with a long-term follow-up in October 2020. In June 2014, a standardized surgical treatment for burst abdomen involving a monofilament, slowly absorbable suture in a continuous mass-closure stitch with large bites of 3 cm and small steps of 5 mm was introduced. The occurrence of incisional hernia was investigated and defined as a radiological-, clinical-, or intraoperative finding of a hernia in the abdominal midline incision at follow-up. RESULTS: Ninety-four patients suffered from burst abdomen during the study period. Eighty patients were eligible for follow-up. The index surgery prior to burst abdomen was an emergency laparotomy in 78% (62/80) of the patients. Nineteen patients died within the first 30 postoperative days and 61 patients were available for further analysis. The long-term incisional hernia rate was 33% (20/61) with a median follow-up of 17 months (min 4, max 67 months). CONCLUSION: Standardized surgery for burst abdomen with a mass-closure technique using slow absorbable running suture results in high rates of long-term incisional hernias, comparable to the hernia rates reported in the literature among this group of patients.
Authors: Clinton Webster; Leigh Neumayer; Randall Smout; Susan Horn; Jennifer Daley; William Henderson; Shukri Khuri Journal: J Surg Res Date: 2003-02 Impact factor: 2.192
Authors: Jerry J Kim; Mike K Liang; Anuradha Subramanian; Courtney J Balentine; Shubhada Sansgiry; Samir S Awad Journal: Am J Surg Date: 2011-09-23 Impact factor: 2.565
Authors: Gabrielle H van Ramshorst; Hasan H Eker; Jan A van der Voet; Johannes Jeekel; Johan F Lange Journal: J Gastrointest Surg Date: 2013-05-29 Impact factor: 3.452
Authors: Christoph M Seiler; Thomas Bruckner; Markus K Diener; Armine Papyan; Henriette Golcher; Christoph Seidlmayer; Annette Franck; Meinhard Kieser; Markus W Büchler; Hanns-Peter Knaebel Journal: Ann Surg Date: 2009-04 Impact factor: 12.969