Mini Review ARTICLE
Prevention of incisional hernias after open abdomen treatment
- 1General and HPB Surgery and Liver Transplantation, Ghent University Hospital, Belgium
Management of the open abdomen patient is difficult and primary closure of the fascial edges is essential to obtain best patients’ outcome regardless of the initial etiology of the open abdomen. The use of temporary abdominal closure devices is nowadays the gold standard to have the highest closure rates with mesh mediated fascial traction as the proposed standard of care. However, the incidence of incisional hernias, although much more controlled than when leaving an abdomen open, is high and reaches up to 65%.
As shown for other high risk patient subgroups, such as obese patients, patients after abdominal aneurysm treatment and patients with former –ostomy sites, prevention of incisional hernias might be key to further optimize patient measured outcomes after open abdomen treatment. In this overview, current available modalities to possible decrease the incidence of incisional hernia are discussed. Most of these preventive options have been shown effective in giant ventral hernia repair and might work effectively in this patient cohort as well.
Keywords: Open abdomen, prevention, incisional hernia, closure, negative pressure therapy, botoxulin, Component separation
Received: 26 Dec 2017;
Accepted: 02 Feb 2018.
Edited by:Gabriel Sandblom, Karolinska Institute (KI), Sweden
Reviewed by:Wagih M. Ghannam, Mansoura University, Egypt
Hakan Kulacoglu, Recep Tayyip Erdoğan University, Turkey
Copyright: © 2018 Berrevoet. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Frederik Berrevoet, Ghent University Hospital, General and HPB Surgery and Liver Transplantation, De Pintelaan 185, Ghent, 9000, Belgium, Frederik.Berrevoet@Ugent.be