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01-04-2020 | Abdominal Compartment Syndrome | Original Article

Emergency repair of complicated abdominal wall hernias: WSES guidelines

Authors: B. De Simone, A. Birindelli, L. Ansaloni, M. Sartelli, F. Coccolini, S. Di Saverio, V. Annessi, F. Amico, F. Catena

Published in: Hernia | Issue 2/2020

Abstract

Purpose

In July 2013, the World Society of Emergency Surgery (WSES) held the first Consensus Conference on emergency repair of abdominal wall hernias in adult patients with the intention of producing evidence-based guidelines to assist surgeons in the management of complicated abdominal wall hernias. Guidelines were updated in 2017 in keeping with varying clinical practice: benefits resulting from the increased use of biological prosthesis in the emergency setting were highlighted, as previously published in the World Journal of Emergency Surgery. This executive summary is intended to consolidate knowledge on the emergency management of complicated hernias by providing the broad readership with a practical and concise version of the original guidelines.

Methods

This executive manuscript summarizes the WSES guidelines reporting on the emergency management of complicated abdominal wall hernias; statements are highlighted focusing the readers’ attention on the main concepts presented in the original guidelines.

Conclusions

Emergency repair of complicated abdominal hernias remains one of the most common and challenging surgical emergencies worldwide. WSES aims to provide an essential version of the evidence-based guidelines focusing on the timing of intervention, laparoscopic approach, surgical repair following the Centers for Disease Control and Prevention (CDC) wound classification, antimicrobial prophylaxis and anesthesia in the emergency setting.

Brozek JL, Akl EA, Compalati E et al (2011) Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 3 of 3. The GRADE approach to developingrecommendations. Allergy 64(8):1109–1116. https://doi.org/10.1111/j.1398-9995.2009.02083.x CrossRef

Martínez-Serrano MA, Pereira JA, Sancho J, Argudo N, López-Cano M, Grande L (2012) Specific improvement measures to reduce complications and mortality after urgent surgery in complicated abdominal wall hernia. Hernia 16(2):171–177. https://doi.org/10.1007/s10029-011-0875-0 CrossRefPubMed

Koizumi M, Sata N, Kaneda Y et al (2014) Optimal timeline for emergency surgery in patients with strangulated groin hernias. Hernia 18(6):845–848. https://doi.org/10.1007/s10029-014-1219-7 CrossRefPubMed

Derici H, Unalp HR, Bozdag AD, Nazli O, Tansug T, Kamer E (2007) Factors affecting morbidity and mortality in incarcerated abdominal wall hernias. Hernia 11(4):341–346. https://doi.org/10.1007/s10029-007-0226-3 CrossRefPubMed

Ge BJ, Huang Q, Liu LM, Bian HP, Fan YZ (2010) Risk factors for bowel resection and outcome in patients with incarcerated groin hernias. Hernia 14(3):259–264. https://doi.org/10.1007/s10029-009-0602-2 CrossRefPubMed

Tsumura H, Ichikawa T, Hiyama E, Murakami Y, Sueda T (2004) Systemic inflammatory response syndrome (SIRS) as a predictor of strangulated small bowel obstruction. Hepatogastroenterology 51(59):1393–1396PubMed

Jancelewicz T, Vu LT, Shawo AE, Yeh B, Gasper WJ, Harris HW (2009) Predicting strangulated small bowel obstruction: an old problem revisited. J Gastrointest Surg. 13(1):93–99. https://doi.org/10.1007/s11605-008-0610-z CrossRefPubMed

Kahramanca S, Kaya O, Ozgehan G et al (2014) Are fibrinogen and complete blood count parameters predictive in incarcerated abdominal hernia repair? Int Surg 99(6):723–728. https://doi.org/10.9738/INTSURG-D-13-00107.1 CrossRefPubMedPubMedCentral

Balthazar EJ (1994) CT of small-bowel obstruction. Am J Roentgenol 162:255–261. https://doi.org/10.2214/ajr.162.2.8310906 CrossRef

10.

Landau O, Kyzer S (2004) Emergent laparoscopic repair of incarcerated incisional and ventral hernia. Surg Endosc Other Interv Tech 18(9):1374–1376. https://doi.org/10.1007/s00464-003-9116-7 CrossRef

11.

Olmi S, Cesana G, Erba L, Croce E (2009) Emergency laparoscopic treatment of acute incarcerated incisional hernia. Hernia 13(6):605–608. https://doi.org/10.1007/s10029-009-0525-y CrossRefPubMed

12.

Deeba S, Purkayastha S, Paraskevas P, Athanasiou T, Darzi A, Zacharakis E (2009) Laparoscopic approach to incarcerated and strangulated inguinal hernias. JSLS J Soc Laparoendosc Surg. 13(3):327–331

13.

Yang GPC, Chan CTY, Lai ECH, Chan OCY, Tang CN, Li MKW (2012) Laparoscopic versus open repair for strangulated groin hernias: 188 cases over 4 years. Asian J Endosc Surg. 5(3):131–137. https://doi.org/10.1111/j.1758-5910.2012.00138.x CrossRefPubMed

14.

Sajid MS, Ladwa N, Colucci G, Miles WF, Baig MK, Sains P (2013) Diagnostic laparoscopy through deep inguinal ring: a literature-based review on the forgotten approach to visualize the abdominal cavity during emergency and elective groin hernia repair. Surg Laparosc Endosc Percutan Tech 23:251–254. https://doi.org/10.1097/SLE.0b013e31828dacc5 CrossRefPubMed

15.

Lee J, Mabardy A, Kermani R, Lopez M, Pecquex N, McCluney A (2013) Laparoscopic vs open ventral hernia repair in the era of obesity. JAMA Surg. 148(8):723–726. https://doi.org/10.1001/jamasurg.2013.1395 CrossRefPubMed

16.

Venara A, Hubner M, Le Naoures P, Hamel JF, Hamy A, Demartines N (2014) Surgery for incarcerated hernia: short-term outcome with or without mesh. Langenbeck’s Arch Surg. 399(5):571–577. https://doi.org/10.1007/s00423-014-1202-x CrossRef

17.

Bessa S, Abdel-Razek A (2013) Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated ventral hernias: a seven years study. Hernia 17(1):59–65. https://doi.org/10.1007/s10029-012-0938-x CrossRefPubMed

18.

Abd Ellatif ME, Negm A, Elmorsy G, Al-Katary M, Yousef AEAM, Ellaithy R (2012) Feasibility of mesh repair for strangulated abdominal wall hernias. Int J Surg. 10(3):153–156. https://doi.org/10.1016/j.ijsu.2012.02.004 CrossRefPubMed

19.

Bessa SS, Abdel-fattah MR, Al-Sayes IA, Korayem IT (2015) Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias: a 10-year study. Hernia 19(6):909–914. https://doi.org/10.1007/s10029-015-1360-y CrossRefPubMed

20.

Campanelli G, Nicolosi F, Pettinari D, Avesani E (2004) Prosthetic repair, intestinal resection, and potentially contaminated areas: safe and feasible? Hernia 8:190–192. https://doi.org/10.1007/s10029-004-0242-5 CrossRefPubMed

21.

Xourafas D, Lipsitz SR, Negro P, Ashley SW, Tavakkolizadeh A (2010) Impact of mesh use on morbidity following ventral hernia repair with a simultaneous bowel resection. Arch Surg 145(8):739–744. https://doi.org/10.1001/archsurg.2010.144 CrossRefPubMed

22.

Choi JJ, Palaniappa NC, Dallas KB, Rudich TB, Colon MJ, Divino CM (2012) Use of mesh during ventral hernia repair in clean–contaminated and contaminated cases: outcomes of 33,832 cases. Ann Surg 255(1):176–180. https://doi.org/10.1097/SLA.0b013e31822518e6 CrossRefPubMed

23.

Nieuwenhuizen J, Van Ramshorst GH, Ten Brinke JG et al (2011) The use of mesh in acute hernia: frequency and outcome in 99 cases. Hernia 15(3):297–300. https://doi.org/10.1007/s10029-010-0779-4 CrossRefPubMedPubMedCentral

24.

Zafar H, Zaidi M, Qadir I, Memon A (2012) Emergency incisional hernia repair: a difficult problem waiting for a solution. Ann Surg Innov Res. 6:1. https://doi.org/10.1186/1750-1164-6-1 CrossRefPubMedPubMedCentral

25.

Haskins IN, Amdur RL, Lin PP, Vaziri K (2016) The use of mesh in emergent ventral hernia repair: effects on early patient morbidity and mortality. J Gastrointest Surg. 20(11):1899–1903. https://doi.org/10.1007/s11605-016-3207-y CrossRefPubMed

26.

Wysocki A, Kulawik J, Poźniczek M, Strzałka M (2006) Is the Lichtenstein operation of strangulated groin hernia a safe procedure? World J Surg 30(11):2065–2070. https://doi.org/10.1007/s00268-005-0416-z CrossRefPubMed

27.

Ueda J, Nomura T, Sasaki J et al (2012) Prosthetic repair of an incarcerated groin hernia with small intestinal resection. Surg Today 42(4):359–362. https://doi.org/10.1007/s00595-011-0019-2 CrossRefPubMed

28.

Hentati H, Dougaz W, Dziri C (2014) Mesh repair versus non-mesh repair for strangulated inguinal hernia: systematic review with meta-analysis. World J Surg. 38:2784–2790CrossRef

29.

Kelly ME, Behrman SW (2002) The safety and efficacy of prosthetic hernia repair in clean–contaminated and contaminated wounds. Am Surg 68(6):524–528PubMed

30.

Carbonell AM, Criss CN, Cobb WS, Novitsky YW, Rosen MJ (2013) Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg 217(6):991–998. https://doi.org/10.1016/j.jamcollsurg.2013.07.382 CrossRefPubMed

31.

Coccolini F, Agresta F, Bassi A et al (2012) Italian Biological Prosthesis Work-Group (IBPWG): proposal for a decisional model in using biological prosthesis. World J Emerg Surg. 7(1):34. https://doi.org/10.1186/1749-7922-7-34 CrossRefPubMedPubMedCentral

32.

Saettele TM, Bachman SL, Costello CR et al (2007) Use of porcine dermal collagen as a prosthetic mesh in a contaminated field for ventral hernia repair: a case report. Hernia 11(3):279–285. https://doi.org/10.1007/s10029-006-0186-z CrossRefPubMed

33.

Smart N, Immanuel A, Mercer-Jones M (2007) Laparoscopic repair of a Littre’s hernia with porcine dermal collagen implant (Permacol). Hernia 11(4):373–376. https://doi.org/10.1007/s10029-007-0197-4 CrossRefPubMed

34.

Albo D, Awad SS, Berger DH, Bellows CF (2006) Decellularized human cadaveric dermis provides a safe alternative for primary inguinal hernia repair in contaminated surgical fields. Am J Surg. https://doi.org/10.1016/j.amjsurg.2006.08.029 CrossRefPubMed

35.

Patton JH, Berry S, Kralovich KA (2007) Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions. Am J Surg 193(3):360–363. https://doi.org/10.1016/j.amjsurg.2006.09.021 CrossRefPubMed

36.

Catena F, Ansaloni L, Gazzotti F et al (2007) Use of porcine dermal collagen graft (Permacol) for hernia repair in contaminated fields. Hernia 11(1):57–60. https://doi.org/10.1007/s10029-006-0171-6 CrossRefPubMed

37.

Coccolini F, Catena F, Bertuzzo VR, Ercolani G, Pinna A, Ansaloni L (2013) Abdominal wall defect repair with biological prosthesis in transplanted patients: single center retrospective analysis and review of the literature. Updat Surg. 65(3):191–196. https://doi.org/10.1007/s13304-013-0212-5 CrossRef

38.

Coccolini F, Poiasina E, Bertoli P et al (2013) The Italian register of biological prostheses. Eur Surg Res 50(3–4):262–272. https://doi.org/10.1159/000351333 CrossRefPubMed

39.

Smart NJ, Marshall M, Daniels IR (2012) Biological meshes: a review of their use in abdominal wall hernia repairs. Surgeon 10(3):159–171. https://doi.org/10.1016/j.surge.2012.02.006 CrossRefPubMed

40.

Primus FE, Harris HW (2013) A critical review of biologic mesh use in ventral hernia repairs under contaminated conditions. Hernia 17(1):21–30. https://doi.org/10.1007/s10029-012-1037-8 CrossRefPubMedPubMedCentral

41.

Bondre IL, Holihan JL, Askenasy EP et al (2016) Suture, synthetic, or biologic in contaminated ventral hernia repair. J Surg Res 200(2):488–494. https://doi.org/10.1016/j.jss.2015.09.007 CrossRefPubMed

42.

Han JG, Pang GY, Wang ZJ, Zhao Q, Ma SZ (2014) The combined application of human acellular dermal matrix and vacuum wound drainage on incarcerated abdominal wall hernias. Int J Surg. 12(5):452–456. https://doi.org/10.1016/j.ijsu.2014.03.019 CrossRefPubMed

43.

Lee L, Mata J, Landry T et al (2014) A systematic review of synthetic and biologic materials for abdominal wall reinforcement in contaminated fields. Surg Endosc Other Interv Tech. 28(9):2531–2546. https://doi.org/10.1007/s00464-014-3499-5 CrossRef

44.

De Simone B, Catena F, Biondi A et al (2016) Incisional Hernia Repair in Contaminated Surgical fields (I.H.R.C.S.) study using biological prostheses in emergency surgery setting with contaminated hernias: a multicenter prospective observational study. J Peritoneum (and other serosal surfaces). https://doi.org/10.4081/joper.2016.26 CrossRef

45.

Leppäniemi A, Tukiainen E (2012) Planned hernia repair and late abdominal wall reconstruction. World J Surg 36:511–515. https://doi.org/10.1007/s00268-011-1177-5 CrossRefPubMed

46.

Harth KC, Krpata DM, Chawla A, Blatnik JA, Halaweish I, Rosen MJ (2013) Biologic mesh use practice patterns in abdominal wall reconstruction: a lack of consensus among surgeons. Hernia 17(1):13–20. https://doi.org/10.1007/s10029-012-1029-8 CrossRefPubMed

47.

Roberts DJ, Ball CG, Kirkpatrick AW (2016) Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome. Curr Opin Crit Care 22(2):174–185PubMed

48.

Leng Y, Zhang K, Fan J et al (2014) Effect of acute, slightly increased intra-abdominal pressure on intestinal permeability and oxidative stress in a rat model. PLoS One. https://doi.org/10.1371/journal.pone.0109350 CrossRefPubMedPubMedCentral

49.

Coccolini F, Roberts D, Ansaloni L et al (2018) The open abdomen in trauma and non-trauma patients: WSES guidelines. World J Emerg Surg 13:7. https://doi.org/10.1186/s13017-018-0167-4 CrossRefPubMedPubMedCentral

50.

Kirkpatrick AW, Roberts DJ, De Waele J, Laupland K (2014) Is intra-abdominal hypertension a missing factor that drives multiple organ dysfunction syndrome? Crit Care 18(2):124. https://doi.org/10.1186/cc13785 CrossRefPubMedPubMedCentral

51.

Kirkpatrick AW, Roberts DJ, Faris PD et al (2015) Active negative pressure peritoneal therapy after abbreviated laparotomy: the intraperitoneal vacuum randomized controlled trial. Ann Surg 262(1):38–46. https://doi.org/10.1097/SLA.0000000000001095 CrossRefPubMedPubMedCentral

52.

Cheatham ML, Demetriades D, Fabian TC et al (2013) Prospective study examining clinical outcomes associated with a negative pressure wound therapy system and Barker’s vacuum packing technique. World J Surg 37(9):2018–2030. https://doi.org/10.1007/s00268-013-2080-z CrossRefPubMedPubMedCentral

53.

Tsuei BJ, Skinner JC, Bernard AC, Kearney PA, Boulanger BR (2004) The open peritoneal cavity: etiology correlates with the likelihood of fascial closure. Am Surg 70:652–656PubMed

54.

Reimer MW, Yelle JD, Reitsma B, Doumit G, Allen MA, Bell MS (2008) Management of open abdominal wounds with a dynamic fascial closure system. Can J Surg 51(3):209–214PubMedPubMedCentral

55.

Boele Van Hensbroek P, Wind J, Dijkgraaf MGW, Busch ORC, Carel Goslings J (2009) Temporary closure of the open abdomen: a systematic review on delayed primary fascial closure in patients with an open abdomen. World J Surg 33(2):199–207. https://doi.org/10.1007/s00268-008-9867-3 CrossRefPubMed

56.

Ramirez OM, Ruas E, Dellon AL (1990) “Components separation” method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg 86(3):519–526. https://doi.org/10.1097/00006534-199009000-00023 CrossRefPubMed

57.

DiBello JN, Moore JH (1996) Sliding myofascial flap of the rectus abdominus muscles for the closure of recurrent ventral hernias. Plast Reconstr Surg 98(3):464–469. https://doi.org/10.1097/00006534-199609000-00016 CrossRefPubMed

58.

Tukiainen E, Leppäniemi A (2011) Reconstruction of extensive abdominal wall defects with microvascular tensor fasciae latae flap. Br J Surg 98(6):880–884. https://doi.org/10.1002/bjs.7489 CrossRefPubMed

59.

Montgomery A (2013) The battle between biological and synthetic meshes in ventral hernia repair. Hernia 17(1):3–11. https://doi.org/10.1007/s10029-013-1043-5 CrossRefPubMed

60.

Sartelli M, Catena F, Ansaloni L et al (2013) Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study). World J Emerg Surg 8:1. https://doi.org/10.1186/1749-7922-8-1 CrossRefPubMedPubMedCentral

61.

Nordin P, Zetterström H, Carlsson P et al (2007) Cost-effectiveness analysis of local, regional and general anaesthesia for inguinal hernia repair using data from a randomized clinical trial. Br J Surg 94(4):500–505. https://doi.org/10.1002/bjs.5543 CrossRefPubMed

62.

Reece-Smith AM, Maggio AQ, Tang TY, Walsh SR (2009) Local anaesthetic vs. general anaesthetic for inguinal hernia repair: systematic review and meta-analysis. Int J Clin Pract. 63(12):1739–1742. https://doi.org/10.1111/j.1742-1241.2009.02131.x CrossRefPubMed

63.

Chen T, Zhang Y, Wang H et al (2016) Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital. BMC Anesthesiol 16:17. https://doi.org/10.1186/s12871-016-0185-2 CrossRefPubMedPubMedCentral

Title: Emergency repair of complicated abdominal wall hernias: WSES guidelines
Authors: B. De Simone
A. Birindelli
L. Ansaloni
M. Sartelli
F. Coccolini
S. Di Saverio
V. Annessi
F. Amico
F. Catena
Publication date: 01-04-2020
Publisher: Springer Paris
Keyword: Abdominal Compartment Syndrome
Published in: Hernia / Issue 2/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-019-02021-8

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Emergency repair of complicated abdominal wall hernias: WSES guidelines

Abstract

Purpose

Methods

Conclusions

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Abstract

Purpose

Methods

Conclusions

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