Updated guideline for closure of abdominal wall incisions from the European and American Hernia Societies
Deerenberg, Eva B. (Franciscus Gasthuis en Vlietland, Rotterdam)
Henriksen, Nadia A. (Herlev University Hospital)
Antoniou, George A. (Manchester University NHS Foundation Trust)
Antoniou, Stavros A. (Mediterranean Hospital of Cyprus)
Bramer, Wichor (Erasmus University Medical Centre)
Fischer, John P. (University of Pennsylvania Health System)
Fortelny, Rene H. (University Salzburg)
Gök, Hakan (Hernia Surgery Centre)
Harris, Hobart W. (University of California San Francisco)
Hope, William (Novant/New Hanover Regional Medical Center)
Horne, Charlotte M. (Penn State Health Department)
Jensen, Thomas K. (Herlev University Hospital)
Köckerling, Ferdinand
Kretschmer, Alexander (Klinikum der Ludwig-Maximillians-Universität München)
López Cano, Manuel (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Malcher, Flavio (NYU Langone Health/NYU Grossman School of Medicine)
Shao, Jenny (University of Pennsylvania)
Slieker, Juliette C. (Kantonsspital Baden)
de Smet, Gijs (rasmus University Medical Centre)
Stabilini, Cesare (Policlinico San Martino IRCCS and Department of Surgical Sciences)
Torkington, Jared (University Hospital of Wales)
Muysoms, Filip (Maria Middelares Hospital)

Fecha:	2022
Resumen:	Incisional hernia is a frequent complication of abdominal wall incision. Surgical technique is an important risk factor for the development of incisional hernia. The aim of these updated guidelines was to provide recommendations to decrease the incidence of incisional hernia. A systematic literature search of MEDLINE, Embase, and Cochrane CENTRAL was performed on 22 January 2022. The Scottish Intercollegiate Guidelines Network instrument was used to evaluate systematic reviews and meta-analyses, RCTs, and cohort studies. The GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation) was used to appraise the certainty of the evidence. The guidelines group consisted of surgical specialists, a biomedical information specialist, certified guideline methodologist, and patient representative. Thirty-nine papers were included covering seven key questions, and weak recommendations were made for all of these. Laparoscopic surgery and non-midline incisions are suggested to be preferred when safe and feasible. In laparoscopic surgery, suturing the fascial defect of trocar sites of 10 mm and larger is advised, especially after single-incision laparoscopic surgery and at the umbilicus. For closure of an elective midline laparotomy, a continuous small-bites suturing technique with a slowly absorbable suture is suggested. Prophylactic mesh augmentation after elective midline laparotomy can be considered to reduce the risk of incisional hernia; a permanent synthetic mesh in either the onlay or retromuscular position is advised. These updated guidelines may help surgeons in selecting the optimal approach and location of abdominal wall incisions.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	British journal of surgery, Vol. 109 Num. 12 (August 2022) , p. 1239-1250, ISSN 1365-2168

DOI: 10.1093/bjs/znac302
PMID: 36026550

12 p, 246.7 KB

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