Published December 15, 2016 | Version v1
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Hernias, aortic surgery and review of the literature on incisional hernias

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Objectives: To study the relation of incisional hernias after abdominal aortic surgery and to study the recommendations for prevention of incisional hernias in general.

Methods: An extensive search in Pub-Med was conducted. We used the following MeSH terms; abdominal aortic aneurysm; incisional hernia; inguinal hernia; incisional hernia and radiology, abdominal wound closure, we also did a “snow-falling” search with the above terms.

Results: Still today there is not unanimity concerning the relation of aortic or aortoiliac pathology and incisional or inguinal hernias although the majority of studies suggest that there is a possible increase in the prevalence of incisional hernias after aortic surgery.

Conclusions: In order to lessen the possibilities of incisional hernias suture length to wound length ration should be more that 4:1. Sutures should be tied without excessive tension and to use either a slowly absorbable or nonabsorbable suture material. Use a suture USP 2/0 mounted on a small needle. Place stitches in the aponeurosis only and 5 to 8mm from the wound edge and 4 to 5 mm apart.

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References

  • Hall KA, et al. Abdominal wall hernias in patients with abdominal aortic aneurysmal versus aortoiliac occlusive disease. Am J Surg 1995;170(6): 572–576.
  • Muysoms F, et al. Classification of primary and incisional abdominal wall hernias. Hernia 2009;13(4): 407–414.
  • Korenkov M, et al. Classification and surgical treatment of incisional hernia. Langenbeck's Arch Surg 2001;386(1): 65–73.
  • Baucom RB, et al. Prospective evaluation of surgeon physical examination for detection of incisional hernias. J Am Coll Surg 2014;218(3): 363–366.
  • Bhangu A, et al. Systematic review and meta-analysis of prophylactic mesh placement for prevention of incisional hernia following midline laparotomy. Hernia 2013;17(4): 445–455.
  • Van't Riet M, et al. Meta-analysis of techniques for closure of midline abdominal incisions. BJS 2002;89(11): 1350–1356.
  • Diener MK, et al. Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg 2010;251(5): 843–856.
  • Norton J, et al. Surgery: Basic science and clinical evidence. 2001: Springer Science & Business Media.
  • Sorensen LT, et al. Smoking is a risk factor for incisional hernia. Arch Surg 2005;140(2): 119–123.
  • Sanders DL, AN Kingsnorth. The modern management of incisional hernias. BMJ 2012: 344.
  • Gislason HGJ, Soreide O. Burst abdomen and incisional hernia after major gastrointestinal operations – comparison of three closure techniques. Eur J Surg 1995;161: 349–354.
  • Harding K, et al. Late development of incisional hernia: and unrecognised problem. BMJ (Clinical research ed.) 1983;286(6364):519.
  • Hesselink V, et al. An evaluation of risk factors in incisional hernia recurrence. SGO 1993;176(3): 228–234.
  • Pollock A, Greenall M, Evans M. Single-layer mass closure of major laparotomies by continuous suturing. J Roy Soc Med 1989;72(12):889.
  • Lord RS, et al. Transverse abdominal incisions compared with midline incisions for elective infrarenal aortic reconstruction: predisposition to incisional hernia in patients with increased intraoperative blood loss. J Vasc Surg 1994;20(1): 27–33.
  • Fassiadis N, et al. Randomized clinical trial of vertical or transverse laparotomy for abdominal aortic aneurysm repair. BJS 2005;92(10):1208–1211.
  • Holland A, et al. Incisional hernias are more common in aneurysmal arterial disease. Eur J Vasc End Surg 1996;12(2): 196–200.
  • Hodgson NC, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg 2000;231(3):436.
  • Henriksen N, et al. Lack of association between inguinal hernia and abdominal aortic aneurysm in a population based male cohort. BJS 2013;100(11): 1478–1482.
  • Stevick C, et al. Ventral hernia following abdominal aortic reconstruction. Am Surg 1988;54(5): 287–289.
  • Mudge M, Hughes L. Incisional hernia: a 10 year prospective study of incidence and attitudes. BJS 1985;72(1): 70–71.
  • Johnson B, Sharp R, Thursby P. Incisional hernias: incidence following abdominal aortic aneurysm repair. J Card Surg 1995;36(5): 487–490.
  • Lord RS, et al. Transverse abdominal incisions compared with midline incisions for elective infrarenal aortic reconstruction: predisposition to incisional hernia in patients with increased intraoperative blood loss. Journal of vascular surgery, 1994;20(1): 27–33.
  • Augestad KM, Wilsgaard T, Solberg S. Incisional hernia after surgery for abdominal aortic aneurysm. Tidsskr Nor Laegforen 2002;122(1):22.
  • Takagi H, et al. Postoperative incision hernia in patients with abdominal aortic aneurysm and aortoiliac occlusive disease: a systematic review. Eur J Vas End Surg 2007;33(2): 177–181.
  • Adye, B, Luna G. Incidence of abdominal wall hernia in aortic surgery. Am J Surg 1998;175(5): 400–402.
  • Musella M, et al. Magnetic resonance imaging and abdominal wall hernias in aortic surgery. JACS 2001; 193(4): 392–395.
  • Luijendijk RW, et al. A comparison of suture repair with mesh repair for incisional hernia. NEJM 2000;343(6): 392–398.
  • Papadimitriou D, et al. Incidence of abdominal wall hernias in patients undergoing aortic surgery for aneurysm or occlusive disease. Vasa 2002;31(2): 111–114.
  • Liapis CD, et al. Incidence of incisional hernias in patients operated on for aneurysm or occlusive disease. Am Surg 2004;70(6): 550–552.
  • Raffetto JD, et al. Incision and abdominal wall hernias in patients with aneurysm or occlusive aortic disease. J Vasc Surg 2003;37(6):1150–1154.
  • Antoniou GA, et al. Abdominal aortic aneurysm and abdominal wall hernia as manifestations of a connective tissue disorder. J Vasc Surg 2011;54(4): 1175–1181.
  • Israelsson L. Incisional hernias in patients with aortic aneurysmal disease: the importance of suture technique. Eur J Vas End Surg 1999;17(2): 133–135.
  • Cannon DJ, Casteel L, Read RC, Abdominal aortic aneurysm, Leriche's syndrome, inguinal herniation, and smoking. Arch Surg 1984;119(4):387–389.
  • Cannon DJ, Read RC, Metastatic emphysema: a mechanism for acquiring inguinal herniation. Ann Surg 1981;194(3): 270.
  • Pleumeekers H, et al. Prevalence of aortic aneurysm in men with a history of inguinal hernia repair. BJS 1999;86(9): 1155–1158.
  • Antoniou GA, et al. Increased prevalence of abdominal aortic aneurysm in patients undergoing inguinal hernia repair compared with patients without hernia receiving aneurysm screening. J Vasc Surg 2011;53(5): 1184–1188.
  • Lehnert B, Wadouh F. High coincidence of inguinal hernias and abdominal aortic aneurysms. Ann Vasc Surg 1992;6(2): 134–137.
  • Golledge J, Reeve T, Norman PE. Abdominal aortic aneurysm, inguinal hernias and emphysema. ANZ J Surg 2008;78(11): 1034–1034.
  • Grondal N, et al. Study protocol The Viborg vascular (VIVA) screening trial of 65–74 year old men in the central region of Denmark: study protocol. Trials 2010.
  • Lindholt JS, et al. Screening for abdominal aortic aneurysms: single centre randomised controlled trial. BJS 2005;330(7494): 750.
  • Ellis H, Gajraj H, George C. Incisional hernias: when do they occur? BJS 1983;70(5): 290–291.
  • Krukowski Z, Matheson N. A Button hole™ incisional hernia: A late complication of abdominal wound closure with continuous nonabsorbable sutures. BJS 1987;74(9): 824–825.
  • Honig MP. Mason RA, Giron F, Wound complications of the retroperitoneal approach to the aorta and iliac vessels. J Vasc Surg 1992;15(1): 28–34.
  • Peck JJ, et al. Extraperitoneal approach for aortoiliac reconstruction of the abdominal aorta. Am J Surg 1986;151(5): 620–623.
  • Luijendijk, RW. Incisional Hernia: lisk factors, prevention, and repair. 2000: Erasmus MC: University Medical Center Rotterdam.
  • Hesselink, V, et al. An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 1993;176(3): 228–234.
  • Luijendijk RW, et al. Incisional hernia recurrence following "vest-overpants" or vertical Mayo repair of primary hernias of the midline. W J Surg 1997;21(1): 62–66.
  • Manninen M, Lavonius M, Perhoniemi V. Results of incisional hernia repair. A retrospective study of 172 unselected hernioplasties. Eur J Surg 1991;157(1): 29–31.
  • Sitzmann J, McFadden D. The internal retention repair of massive ventral hernia. Am Surg 1989;55(12): 719–723.
  • Langer C, et al. Problem of recurrent incisional hernia after mesh repair of the abdominal wall. Chirurg 2001;72(8): 927–933.
  • Israelsson LA, Millbourn D. Closing midline abdominal incisions. Langenbecks Arch Surg 2012;397(8): 1201–1207.
  • O'Dwyer P, Courtney C. Factors involved in abdominal wall closure and subsequent incisional hernia. Surgeon 2003;1(1): 17–22.
  • Douglas D. The healing of aponeurotic incisions. BJS 1952;40(159):79–84.
  • Dudley H. Layered and mass closure of the abdominal wall, A Theoretical and Experimental Analysis. BJS 1970;57(9): 664–667.
  • Goligher J, et al. A controlled clinical trial of three methods of closure of laparotomy wounds. BJS 1975;62(10): 823–829.
  • Irvin T, Koffman C, Duthie H. Layer closure of laparotomy wounds with absorbable and non-absorbable suture materials. BJS 1976;63(10): 793–796.
  • Israelsson L, Jonssonv T. Closure of midline laparotomy incisions with polydioxanone and nylon: the importance of suture technique. BJS 1994;81(11): 1606–1608.
  • Ceydeli A, Rucinski J, Wise L. Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg 2005;62(2): 220–225.
  • Wissing J, et al. Fascia closure after midline laparotomy: results of a randomized trial. BJS 1987;74(8): 738–741.
  • Corman ML, Veidenheimer MC, Coller JA. Controlled clinical trial of three suture materials for abdominal wall closure after bowel operations. Am J Surg 1981;141(4): 510–513.
  • Askew A. A comparison of upper abdominal wound closure with monofilament nylon and polyglycolic acid. Aus N Z J Surg 1983;53(4):353–356.
  • Niggebrugge A, et al. Continuous double loop closure: a new technique for repair of laparotomy wounds. BJS 1997;84(2): 258–261.
  • Mayer A, et al. Compression suture of the abdominal wall: a controlled trial in 302 major laparotomies. BJS 1981;68(9): 632–634.
  • Langer S, Christiansen J. Long-term results after incisional hernia repair. Acta Chir Scand 1984;151(3): 217–219.
  • Pless J, Lontoft E. Giant ventral hernias and their repair. Scand J Plast Reconstr Surg Hand Surg 1984;18(2): 209–213.
  • Bauer JJ, et al. Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE). Ann of Surg 1987;206(6): 765.
  • Rubio P. New technique for repairing large ventral incisional hernias with Marlex mesh. SGO 1986;162(3): 275–276.
  • Read RC, Yoder G. Recent trends in the management of incisional herniation. Arch Surg 1989;124(4): 485–488.
  • Jenkins T. The burst abdominal wound: a mechanical approach. BJS 1976;63(11): 873–876.
  • Israelsson LA, Millbourn D. Prevention of incisional hernias: how to close a midline incision. Surg Clin North Am 2013;93(5): 1027–1040.
  • Israelsson L, Jonsson T. Suture length to wound length ratio and healing of midline laparotomy incisions. BJS 1993;80(10): 1284–1286.
  • Millbourn D, Cengiz Y. Israelsson LA. Effect of stitch length on wound complications after closure of midline incisions: a randomized controlled trial. Arch Surg 2009;144(11): 1056–1059.
  • Gruppo M, et al. Midline abdominal wall incisional hernia after aortic reconstructive surgery: a prospective study. Surgery 2012;151(6):882–888.
  • Israelsson LA, Jonsson T. Overweight and healing of midline incisions: the importance of suture technique. Eur J Surg 1997;163(3): 175–180.
  • Israelsson L, Jonsson L, Wimo A. Cost analysis of incisional hernia repair by suture or mesh. Hernia 2003;7(3): 114–117.
  • Janes A, Cengiz Y, Israelsson LA. Preventing parastomal hernia with a prosthetic mesh: a 5-year follow up of a randomized study. W J Surg 2009;33(1): 118–121.
  • Hidalgo M, et al. Incisional hernia in patients at risk: can it be prevented? Hernia 2011;15(4): 371–375.
  • El-Khadrawy O, et al. Prophylactic prosthetic reinforcement of midline abdominal incisions in high-risk patients. Hernia 2009;13(3):267–274.
  • Bevis P, et al. Randomized clinical trial of mesh versus sutured wound closure after open abdominal aortic aneurysm surgery. BJS 2010;97(10): 1497–1502.
  • Bali C, et al. A comparative study of sutured versus bovine pericardium mesh abdominal closure after open abdominal aortic aneurysm repair. Hernia 2014: 1–5.
  • O'Hare J, Ward J, Earnshaw J. Late results of mesh wound closure after elective open aortic aneurysm repair. Eur J Vasc End Surg 2007;33(4): 412–413.
  • Rogers M, McCarthy R, Earnshaw J. Prevention of incisional hernia after aortic aneurysm repair. Eur J Vas End Surg 2003;26(5): 519–522.
  • Campbell JA, et al. A biomechanical study of suture pullout in linea alba. Surgery;1989 106(5): 888–892.
  • Hogstrom H, Haglund U, Zederfeldt B. Suture technique and early breaking strength of intestinal anastomoses and laparotomy wounds. Acta Chir Scand 1984;151(5): 441–443.
  • Millbourn D. Closure of midline abdominal incisions with small stitches: studies on wound complications and health economy. Studies on wound complications and health economy [Doctoral Thesis]. Umea (Sweden): Umea University, 2012.
  • Deerenberg EB, et al. Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. Lancet 2015.
  • Sanders RJ, DiClementi D, Ireland K. Principles of abdominal wound closure: I. Animal studies. Arch Surg 1977;112(10): 1184–1187.
  • Hoer J, et al. Influence of suture technique on laparotomy wound healing: an experimental study in the rat. Langenbeck's Arch Surg 2001 386(3): 218–223.
  • Cengiz Y, Blomquist P, Israelsson LA, Small tissue bites and wound strength: an experimental study. Arch Surg 2001 136(3): 272–275.
  • Miller PA, et al. Imaging of abdominal hernias. Radiographics 1995 15(2): 333–347.
  • Bennett H, Balfe D. MR imaging of the peritoneum and abdominal wall. Magn Reson Imaging Clin N Am 1995;3(1): 99–120.
  • Mueller M, Truong SN, Schumpelick V. Sonographic diagnosis of abdominal wall relaxation. J Cl Ultr 1999;27(4): 183–186.
  • Grolleau J, et al. Imaging of abdominal wall eventration: role and value of x-ray computed tomography. Ann Chir 1996.
  • Beck WC, et al. Comparative effectiveness of dynamic abdominal sonography for hernia vs computed tomography in the diagnosis of incisional hernia. J Am Coll Surg 2013;216(3): 447–453.
  • Gossios K, et al. Value of CT after laparoscopic repair of postsurgical ventral hernia. Abdom Imaging 2003;28(1): 99–102.
  • De la Pena CG, Romero JV, Garcia JD. The value of CT diagnosis of hernia recurrence after prosthetic repair of ventral incisional hernias. Eur Radiolog 2001;11(7): 1161–1164.
  • Ghahremani GG, et al. CT diagnosis of occult incisional hernias. AJR Am J Roetgenol 1987;148(1): 139–142.
  • Rodriguez HE, et al. Abdominal wall hernias after open abdominal aortic aneurysm repair: prospective radiographic detection and clinical implications. Vasc Endovascular Surg 2004;38(3): 237–240.