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

Published:December 06, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.12.006

      Highlights

      • 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.

      Abstract

      Background

      Few studies have investigated risk factors for recurrence of blunt traumatic abdominal wall hernias (TAWH).

      Methods

      Twenty trauma centers identified repaired TAWH from January 2012 to December 2018. Logistic regression was used to investigate risk factors for recurrence.

      Results

      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.

      Conclusion

      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.

      Graphical abstract

      Keywords

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