Smoking Is a Risk Factor for Incisional Hernia

Sørensen, Lars Tue; Hemmingsen, Ulla; Kirkeby, Lene T.; Kallehave, Finn; Jørgensen, Lars Nannestad

doi:10.1001/archsurg.140.2.119

Cited by 280 publications

(177 citation statements)

References 46 publications

Supporting

Mentioning

161

Contrasting

Unclassified

Order By: Relevance

“…However, in another study, the wound infection rate in smokers was 12% compared with 2% in never-smokers (Sorensen et al 2003). Smoking, increase the risk of wound infection presumably through reduction of the oxidative killing mechanism of neutrophils (Sorensen et al 2005).…”

Section: Resultsmentioning

confidence: 92%

Bacteriological Study of Wound Infection and Antibiotic Susceptibility Pattern of the Isolates

Shrestha

2014

Nepal Journal of Science and Technology

View full text Add to dashboard Cite

Wound infections result in sepsis, limb loss, long hospital stays, higher costs, and are responsible for significant human mortality and morbidity worldwide. The present study was conducted to isolate and identify the causative organisms of wound infection, to determine the antibiotic susceptibility pattern of the isolates and to study the risk factors for wound infection. The study was conducted for six months in which pus specimens collected from 244 patients were processed to investigate etiological agents using standard technique. Disc susceptibility of bacterial agents were then determined. A total of 244 pus samples were collected and 147 (60.20%) samples showed growth. A total of 150 bacterial isolates were isolated; of which 118 (78.67%) were Gram positive and 32 (21.33%) were Gram negative bacteria. Staphylococcus aureus (72.00%) was most common followed by Escherichia coli (6.67%), Citrobacter freundii (5.34%), Staphylococcus epidermidis (4.00%), Pseudomonas aeruginosa (3.33%), Proteus mirabilis (2.00%), Enterococcus faecalis (1.33%), Acinetobacter spp. (1.33%), Klebsiella oxytoca (1.33%), Klebsiella pneumoniae (1.33%), Streptococcus pneumoniae (0.67%) and Streptococcus pyogenes (0.67%). The most effective antibiotic for Gram positive isolates was Gentamicin (77.97%). For Gram negative isolates (except Ps. aeruginosa), Amikacin (74.07%), for Ps. aeruginosa, Amikacin, Ciprofloxacin, Gentamicin and Ofloxacin each with the susceptibility of 80.00% and for Staph. aureus, Cloxacillin (79.63%) were the most effective antibiotics. Hence, the most common isolate in wound infection was Staph. aureus followed by E. coli. Therefore, routine microbiological analysis of the wound specimens and their antibiotic susceptibility testing is recommended that will guide clinician for treatment of wound infection.

show abstract

Section: Resultsmentioning

confidence: 92%

Bacteriological Study of Wound Infection and Antibiotic Susceptibility Pattern of the Isolates

Shrestha

2014

Nepal Journal of Science and Technology

View full text Add to dashboard Cite

show abstract

“…These include patient factors such as diabetes, COPD, abdominal aortic aneurysm, smoking, high BMI and peri-operative factors such as emergency surgery, duration of surgery, blood transfusion and surgical site infection. [2][3][4][5] Our aim, in this retrospective cohort study, was to ascertain any particular factors that lead to the development of a ventral incisional hernia post laparotomy. Through identification of risk factors, we can modify these risk factors in the perioperative period in order to try to reduce the risk of development of VIH.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the development of ventral incisional hernia post abdominal surgery: a retrospective cohort study

2017

View full text Add to dashboard Cite

INTRODUCTIONVentral incisional hernia (VIH) is one of the most common post-operative complications following abdominal surgery. Patients with symptomatic ventral incision hernia have unsatisfactory cosmetic results and impaired quality of life with serious life-threatening disorders including incarceration and bowel strangulation. Long term follow-up after abdominal surgery reveals an incidence rate of 5-25% for ventral incisional hernias. 1Various risk factors for development of VIH have been reported in previous studies. These include patient factors ABSTRACT Background: Ventral incisional hernia (VIH) is one of the most common post-operative complications following abdominal surgery. The objective of this study was to evaluate the rate and risk factors associated with development of a ventral incisional hernia (VIH). Methods: Patients who underwent major abdominal surgery between 2010 and 2012 at a single institution were included in this retrospective cohort study. Data were collected from medical records. The primary outcome was clinical or radiological evidence of incisional hernia; explanatory variables were patient demographics and potential clinico-pathological risk factors for hernia development. Results: A total of 295 patients who underwent laparotomy were analysed. 45 (15.25%) patients were found to have a ventral incisional hernia on follow-up. The median time to development of hernia was 351 days. There were equal numbers of elective (N=22) and emergency (N=23) operations that developed an incisional hernia. Of the explanatory variables considered diabetes, hypertension (HTN) and body mass index (BMI) had persistent significant positive associations with the development of an incisional hernia. On univariable analysis diabetes (HR = 2.73, p-value = 0.004) and hypertension (HR =2.17, p-value = 0.016) were identified as independent risk factors for hernia development. BMI was also significantly associated with development of an incisional hernia on univariate analysis, but due to missing data this did not reach statistical significance on multivariable analysis. Conclusions: Although there are several risk factors to development of VIH, diabetes and HTN were associated with development of incisional hernia in our study. BMI also appears to be an important determinant of development of VIH. Further research in this area is likely to identify an at-risk subset of patients, who may benefit from weight loss prior to surgery or prophylactic mesh post-laparotomy.

show abstract

“…Age (>50) did not have an effect. Sorensen et al (9) found an association with older age and male gender and the formation of a hernia in a series of 916 patients. However, other studies did not find a significant relation with gender and hernia formation (8).…”

Section: Discussionmentioning

confidence: 96%

A prospective evaluation of the risk factors for wound dehiscence and incisional hernia development

Yılmaz

Akıncı

Doğan

et al. 2013

UCD

View full text Add to dashboard Cite

Objective: Post-laparotomy wound dehiscence, evantration and evisceration are important complications leading to an increase in both morbidity and mortality. Incisional hernias are frequently observed following abdominal surgeries and their occurrence is related to various local and systemic factors. This study aims to analyze the factors affecting wound healing by investigating the parameters that may cause wound dehiscence, incisional hernia, sinus formation and chronic incisional pain. Material and Methods:The records of 265 patients who underwent major abdominal surgery were analyzed. The data on patient characteristics, medication, surgical procedure type, type of suture and surgical instruments used and complications were recorded. The patients were followed up with respect to sinus formation, incisional hernia occurrence and presence of chronic incision pain. Statistical analysis was performed using SPSS 10.00 program. The groups were compared via chi-square tests. Significance was determined as p<0.05. Multi-variate analysis was done by forward logistic regression analysis.Results: 115 (43.4%) patients were female and 150 (56.6%) were male. Ninety-four (35.5%) patients were under 50 years old and 171 (64.5%) were older than 50 years. The median follow-up period was 28 months (0-48). Factors affecting wound dehiscence were found to be; creation of an ostomy (p=0.002), postoperative pulmonary problems (p=0.001) and wound infection (p=0.001). Factors leading to incisional hernia were; incision type (p=0.002), formation of an ostomy (p=0.002), postoperative bowel obstruction (p=0.027), postoperative pulmonary problems (p=0.017) and wound infection (p=0.011). Conclusion:Awareness of the factors causing wound dehiscence and incisional hernia in abdominal surgery, means of intervention to the risk factors and taking relevant measures may prevent complications. Surgical complications that occur in the postoperative period are especially related to wound healing problems.Key Words: Abdominal surgery, wound dehiscence, incisional hernia, sinus formation, chronic incisional pain INTRODUCTIONWound dehiscence after laparotomy can manifest with different presentations varying from simple skin detachment to evisceration and eventration, leading to an increase in surgical mortality and morbidity, as well as increase in length of hospital stay and loss of work force.Anterior abdominal wall incision hernia that can be seen in the long term is also one of the common surgical complications. Known as postoperative hernia or incisional hernia, it is thought to result from insufficient closure of the fascia and/or poor healing. Factors causing chronic or prolonged postoperative intra-abdominal pressure increase and those affecting wound healing contribute to its development. The incidence of incisional hernias vary from 2% to 20% in different sources, and in addition to pain and impairment in quality of life it may also cause significant complications (1, 2). It has been reported that incarceration may occur in a rate of 15%, ...

show abstract

Smoking Is a Risk Factor for Incisional Hernia

Cited by 280 publications

References 46 publications

Bacteriological Study of Wound Infection and Antibiotic Susceptibility Pattern of the Isolates

Bacteriological Study of Wound Infection and Antibiotic Susceptibility Pattern of the Isolates

Factors affecting the development of ventral incisional hernia post abdominal surgery: a retrospective cohort study

A prospective evaluation of the risk factors for wound dehiscence and incisional hernia development

Contact Info

Product

Resources

About