Paasch Christoph, Lorenz Eric, Anders Stefan, De Santo Gianluca, Boettge Katherina, Gauger Ulrich, Croner Roland, Strik Martin W
Department of General, Visceral and Cancer Surgery, Helios Klinikum Berlin-Buch, Berlin, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
Department of General, Abdominal and Vascular Surgery, University Hospital, Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
Ann Med Surg (Lond). 2019 Jun 15;44:5-12. doi: 10.1016/j.amsu.2019.06.005. eCollection 2019 Aug.
Incisional hernias of the abdominal wall are frequent complications after laparotomy (9-20%) and often need incisional hernia repair (IHR). In order to ensure wound healing and to therefore prevent postoperative short and long term morbidity carrying an abdominal binder (AB) and physical rest is frequently advised. However, there is a lack of evidence concerning clinical effects regarding these recommendations. Hence, we conducted a survey to analyze the patient reported outcome following IHR.
From December 2017 to May 2018, we conducted a survey among 270 patients who underwent open and laparoscopic IHR at two maximum care hospitals. They were interviewed about their type of operation, postoperative treatment, recommendations, and outcome.
163 patients replied to the questionnaire. The average age was 63.2 ± 12 years. 74 patients were female and 89 were male. 32.6% of the patients reported an AB-induced immobility and 71.2% reported that the AB reduced pain after IHR. A prolonged period of physical rest and the use of an AB had no statistical significance on postoperative morbidity.
Due to our findings we assume that the AB may induce immobility and reduce postoperative pain. A prolonged period of physical rest and wearing an AB does not seem to have an impact on the postoperative outcome following IHR. Therefore, a shortened duration of physical rest and wearing an AB following IHR should be taken under consideration. To reveal more evidence on this topic further clinical trials are essential.
腹壁切口疝是剖腹手术后常见的并发症（发生率为9%-20%），常需进行切口疝修补术（IHR）。为确保伤口愈合，从而预防术后短期和长期并发症，通常建议使用腹带（AB）并进行身体休息。然而，关于这些建议的临床效果缺乏证据。因此，我们进行了一项调查，以分析IHR术后患者报告的结果。
2017年12月至2018年5月，我们对两家大型医院接受开放和腹腔镜IHR的270例患者进行了调查。询问了他们的手术类型、术后治疗、建议和结果。
163例患者回复了问卷。平均年龄为63.2±12岁。女性74例，男性89例。32.6%的患者报告腹带导致活动不便，71.2%的患者报告腹带减轻了IHR术后的疼痛。长时间的身体休息和使用腹带对术后并发症无统计学意义。
根据我们的研究结果，我们认为腹带可能导致活动不便并减轻术后疼痛。长时间的身体休息和佩戴腹带似乎对IHR术后的结果没有影响。因此，应考虑缩短IHR术后的身体休息时间和佩戴腹带的时间。为了揭示更多关于这个主题的证据，进一步的临床试验至关重要。
