Hernias, aortic surgery and review of the literature on incisional hernias
Objectives: To study the relation of incisional hernias after abdominal aortic surgery and to study the recommendations for prevention of incisional hernias in general.
Methods: An extensive search in Pub-Med was conducted. We used the following MeSH terms; abdominal aortic aneurysm; incisional hernia; inguinal hernia; incisional hernia and radiology, abdominal wound closure, we also did a “snow-falling” search with the above terms.
Results: Still today there is not unanimity concerning the relation of aortic or aortoiliac pathology and incisional or inguinal hernias although the majority of studies suggest that there is a possible increase in the prevalence of incisional hernias after aortic surgery.
Conclusions: In order to lessen the possibilities of incisional hernias suture length to wound length ration should be more that 4:1. Sutures should be tied without excessive tension and to use either a slowly absorbable or nonabsorbable suture material. Use a suture USP 2/0 mounted on a small needle. Place stitches in the aponeurosis only and 5 to 8mm from the wound edge and 4 to 5 mm apart.
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