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

• Published in: The American journal of surgery Vol. 225; no. 6; pp. 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: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2023; Elsevier Limited
• 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; Hernia; Abdominal trauma; Trauma; Traumatic abdominal wall hernia
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.12.006

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.