Department of General, Visceral and Cancer Surgery, HELIOS Klinikum Berlin-Buch, Berlin, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
Department of General, Visceral and Cancer Surgery, HELIOS Klinikum Berlin-Buch, Berlin, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
Int J Surg. 2018 May;53:320-325. doi: 10.1016/j.ijsu.2018.04.014. Epub 2018 Apr 12.
Incisional hernias of the abdominal wall are frequent complication after laparotomy (9-20%). Open incisional hernia repair with sublay mesh placement (SMP) on the posterior rectus sheath is described as being a sufficient method for repairing incisional hernia. In order to ensure wound healing and to therefore prevent recurrence, carrying an abdominal binder (AB) or a pressure dressing (PD) and physical rest for a certain time is the common postoperative recommendation, though the evidence for post-operative treatment is low. Hence, we conducted a survey to reveal the different recommendations given by surgical departments (SD).
We conducted a survey among 65 German SDs of the XXX Hospital Group. The SDs were interviewed about the number of open incisional hernia repair with SMP in the time frame of 2013-2014, the known recurrence rate (RR), their recommended prescription of the AB/PD and the time of physical rest.
The head physicians of 48 surgical departments answered the questionnaire. The survey revealed 42 different recommendations of postoperative-treatment. The majority of the SDs advices 4 weeks (20,5%) of physical rest and no prescription of the AB (29,5%). No correlation between the known RR and the duration of physical rest was detected. No head physician's prescribes a PD.
Due to our findings we assume that a short period of physical rest is a considerable postoperative treatment following an open incisional hernia repair with SMP. By reducing the individual incapacity for work and immobility this would have a social-economic impact. The use of a PD may prevent seroma formation. Further investigations with randomized clinical trials are mandatory to support our hypothesis.
腹壁切口疝是剖腹手术后的常见并发症（9-20%）。在腹直肌后鞘下方放置补片的开放式切口疝修补术（SMP）被描述为修复切口疝的一种充分方法。为了确保伤口愈合，从而防止复发，在一定时间内使用腹部束带（AB）或压力敷料（PD）和身体休息是常见的术后建议，尽管术后治疗的证据不足。因此，我们进行了一项调查，以揭示不同外科部门（SD）的不同建议。
我们对 XXX 医院集团的 65 个德国 SD 进行了一项调查。SD 被问及在 2013-2014 年期间进行的开放式切口疝修补 SMP 的数量、已知的复发率（RR）、他们推荐的 AB/PD 处方和身体休息的时间。
48 个外科部门的主任医师回答了问卷。调查显示，有 42 种不同的术后治疗建议。大多数 SD 建议 4 周（20.5%）的身体休息和不使用 AB（29.5%）。没有发现已知 RR 与身体休息时间之间存在相关性。没有主任医师开 PD。
根据我们的发现，我们假设在开放式切口疝修补 SMP 后，短时间的身体休息是一种重要的术后治疗方法。通过减少个人的工作和行动不便，这将对社会经济产生影响。使用 PD 可能会防止血清肿形成。需要进行进一步的随机临床试验调查，以支持我们的假设。
