Hernia Research Today is a free monthly online journal that collates and summarizes the latest research about Hernia, including details on hiatal, inguinal, umbilical, abdominal, treatment.

Delayed closure of ventral abdominal hernias after severe trauma.

Ekeh AP, McCarthy MC, Woods RJ, Walusimbi M, Saxe JM, Patterson LA

Department of Surgery, Wright State University, CHE 7000, Miami Valley Hospital, 1 Wyoming Street, Dayton, OH 45459, USA. peter.ekeh@wright.edu

BACKGROUND: Primary closure after trauma celiotomies is not always accomplished. We reviewed our experience with delayed closure in trauma patients. METHODS: Prospective data were collected on patients who had damage-control celiotomy and were discharged with open abdomens. The time to closure, repair methods, and complication data also were compiled. RESULTS: In the 6-year period, 84 patients underwent damage-control celiotomy. Thirty-one patients died and 33 patients had early closure. Twenty patients had closure during a subsequent hospitalization (mean time to delayed closure, 193 days): 8 patients (40%) had component separation, 3 (15%) had component separation with mesh, 4 (20%) had mesh alone, and primary closure occurred in 5 (25%). Nine patients (45%) had complications such as wound and mesh infections, hernias, and fistulas. Repair before or after 6 months showed no statistically significant difference for the presence of complications or enterotomies (P = .64 and .5743, respectively). CONCLUSIONS: Open-abdomen reconstruction presents significant challenges. Closure within 6 months is possible; the presence of complications is not affected by early repair.

Published 21 February 2006 in Am J Surg, 191(3): 391-5.
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