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Long term follow up for incisional hernia after severe secondary peritonitis—incidence and risk factors

Mohammed R. Moussavian, M.D., Jochen Schuld, M.D., Daniel Dauer, M.D., Christoph Justinger, M.D., Otto Kollmar, M.D., Martin K. Schilling, M.D., Sven Richter, M.D.Corresponding Author Informationemail address

Received 14 April 2009; received in revised form 17 August 2009 published online 01 February 2010.
Corrected Proof

Abstract 

Background

In patients with secondary peritonitis, infections of the abdominal cavity might render the abdominal wall susceptible to secondary complications such as incisional hernia (IH).

Methods

One hundred ninety-eight patients treated for secondary peritonitis underwent midline laparotomy. Ninety-two surviving patients accessible to clinical follow-up were examined for the occurrence of IH, and risk factors at the time of surgery or during follow-up were determined.

Results

During a median follow-up period of 6 years, 54.3% of the patients developed IHs. A high body mass index, coronary heart disease, intense blood loss, requirement for intraoperative or postoperative transfusions, and small bowel perforation as a source of peritonitis were associated with IH.

Conclusions

IH occurs quite frequently after surgery for secondary peritonitis. Preexisting risk factors for IH and intraoperative blood loss or requirement for blood transfusions were correlated with the development of IH. Interestingly, surgical technique was not correlated with the development of IH in this series.

Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg, Germany

Corresponding Author InformationCorresponding author. Tel.: 49-6841-1631010; fax: 49-6841-1631012

PII: S0002-9610(09)00793-4

doi:10.1016/j.amjsurg.2009.08.043

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