title: Ventral hernia and other complications of 1,000 midline incisions.
abstract: We report the outcome in 1,079 consecutive clean or clean-contaminated midline abdominal incisions closed with running 0-loop nylon suture after both elective and emergency operations done between 1984 and 1991. Postoperatively, 79 patients were lost to follow-up, resulting in 1,000 having long-term follow-up. Mean follow-up among these patients was 22 months. Early wound complications included subcutaneous wound infection (18), deep wound infection (17), dehiscence (13), fistula (2), and suture sinus (2). A ventral hernia developed in 42 (4.2%) cases during follow-up. By chi-square analysis, wound infection, dehiscence, class of clean-contaminated wound, patient age > 65, or previous midline abdominal incision were not identified as risk factors for development of a ventral hernia. Reuse of a previous midline incision in combination with any wound infection was associated with an increased risk of subsequent ventral hernia (stepwise regression). In our experience, running closure of a vertical midline abdominal wound has not been associated with an excessive incidence of wound complications or of ventral hernia.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee 53226, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Carlson
authors.forename: K A
authors.initials: KA
authors.lastname: Ludwig
authors.forename: R E
authors.initials: RE
authors.lastname: Condon
mesh_terms: D016009:Chi-Square Distribution; D017558:Elective Surgical Procedures; D004630:Emergencies; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008875:Middle Aged; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome