Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Few studies have investigated risk factors for recurrence of blunt traumatic abdominal wall hernias (TAWH). Twenty trauma centers identified repaired TAWH from January 2012 to December 2018. Logistic regression was used to investigate risk factors for recurrence. TAWH were repaired in 175 patients w...

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Published in:The American journal of surgery 2023-06, Vol.225 (6), p.1069-1073
Main Authors: Harrell, Kevin N., Grimes, Arthur D., Gill, Harkanwar, Reynolds, Jessica K., Ueland, Walker R., Sciarretta, Jason D., Todd, Samual R., Trust, Marc D., Ngoue, Marielle, Thomas, Bradley W., Ayuso, Sullivan A., LaRiccia, Aimee, Spalding, M Chance, Collins, Michael J., Collier, Bryan R., Karam, Basil S., de Moya, Marc A., Lieser, Mark J., Chipko, John M., Haan, James M., Lightwine, Kelly L., Cullinane, Daniel C., Falank, Carolyne R., Phillips, Ryan C., Kemp, Michael T., Alam, Hasan B., Udekwu, Pascal O., Sanin, Gloria D., Hildreth, Amy N., Biffl, Walter L., Schaffer, Kathryn B., Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L., Maxwell, Robert A.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Injuries - complications
Abdominal Injuries - epidemiology
Abdominal Injuries - surgery
Abdominal trauma
Abdominal wall
Abdominal Wall - surgery
Female
Females
Finite element method
Hernia
Hernia, Abdominal - surgery
Hernia, Ventral - surgery
Hernias
Hospitalization
Hospitals
Humans
Injuries
Intestine
Laparotomy
Laparotomy - adverse effects
Length of stay
Medical records
Patients
Regression analysis
Risk Factors
Secondary analysis
Sex
Surgical Mesh - adverse effects
Trauma
Trauma centers
Traumatic abdominal wall hernia
Variables
Ventilators
Wounds, Nonpenetrating - complications
Wounds, Nonpenetrating - surgery
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Summary:Few studies have investigated risk factors for recurrence of blunt traumatic abdominal wall hernias (TAWH). Twenty trauma centers identified repaired TAWH from January 2012 to December 2018. Logistic regression was used to investigate risk factors for recurrence. TAWH were repaired in 175 patients with 21 (12.0%) known recurrences. No difference was found in location, defect size, or median time to repair between the recurrence and non-recurrence groups. Mesh use was not protective of recurrence. Female sex, injury severity score (ISS), emergency laparotomy (EL), and bowel resection were associated with hernia recurrence. Bowel resection remained significant in a multivariable model. Female sex, ISS, EL, and bowel resection were identified as risk factors for hernia recurrence. Mesh use and time to repair were not associated with recurrence. Surgeons should be mindful of these risk factors but could attempt acute repair in the setting of appropriate physiologic parameters. [Display omitted] •Bowel resection is a recurrence risk factor in blunt traumatic abdominal wall hernias.•Time to repair and mesh use are not associated with recurrence.•Early repair of these injuries is feasible.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2022.12.006