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Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 32-36

Fundamentals of incisional hernia prevention

Department of Surgery, New Hanover Regional Medical Center, Wilmington, North Carolina, USA

Correspondence Address:
William W Hope
Department of Surgery, New Hanover Regional Medical Center, 2131 South 17th Street, Post Box 9025, Wilmington, North Carolina 28401
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijawhs.ijawhs_3_18

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BACKGROUND: The incidence of incisional hernia following surgery is a major economical and clinical burden for healthcare. METHODS: This report reviews and consolidates pertinent literature related to hernia prevention to give surgeons a solid framework on the current perspectives and emerging topics related to incisional hernia prevention. RESULTS: Pertinent anatomy and fundamentals of laparotomy closures are reviewed. Recommended closures of laparotomy incisions include the use of monofilament, slowly absorbing suture in a running fashion with a 4:1 suture to wound length ratio using a short stitch technique. The use of prophylactic mesh reduces the rate of incisional and parastomal hernias in high-risk patients. CONCLUSION: The current fundamentals of hernia prevention including pertinent anatomy and surgical techniques for appropriate laparotomy closures should be known to surgeons operating on the abdominal wall. The use of prophylactic mesh to reduce incisional and parastomal hernias has shown promise, and further research is needed to evaluate long-term efficacy.

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