Predisposing Factors and Occurrence Rate of Incisional Hernia after Open Abdomen Management

Abstract

In recent years, since the number of surviving patients managed with open abdomen (OA) has been increasing very rapidly, management of some challenging sequel such as Incisional hernia (IH) come into consideration. We would like to report our case series of IH developing after OA management and investigate the predisposing factors for hernia occurrence following OA management. Methods: Data of OA patients managed between 2008 and 2014 were analyzed retrospectively. Only the fascial closure achieved OA patients were included in this study and examined in terms of IH. Results: Abdominal closure was achieved in 98(%90) of 108 OA patients. Complete closure (Fascial and skin) could be done in 63 OA patients and only skin closure was achieved in 35 OA patients. Complete closure achieved OA patients were included in this study. Mean follow up time was 20,8±13,6 months.18.3% of them had hernias. Mean Mannheim Peritonitis Index (MPI) score and Sequential Organ Failure Assessment (SOFA) score during OA management were significantly greater in hernia group than nonhernia group. The time interval between first laparotomy to first negative pressure therapy (NPT) application (time interval to first NPT) and the length of OA management were significantly longer in hernia group than non-hernia group. IH may be repaired approximately 144 days later from OA management. Conclusion:Time interval to first NPT application and length of OA management were significantly longer in hernia group. If fascial closure could be achieved during OA management, reasonable ratios of IH with acceptable diameter might occur.