title: Long term follow up for incisional hernia after severe secondary peritonitis-incidence and risk factors.
abstract: BACKGROUND
  In patients with secondary peritonitis, infections of the abdominal cavity might render the abdominal wall susceptible to secondary complications such as incisional hernia (IH).
  
  
  METHODS
  One hundred ninety-eight patients treated for secondary peritonitis underwent midline laparotomy. Ninety-two surviving patients accessible to clinical follow-up were examined for the occurrence of IH, and risk factors at the time of surgery or during follow-up were determined.
  
  
  RESULTS
  During a median follow-up period of 6 years, 54.3% of the patients developed IHs. A high body mass index, coronary heart disease, intense blood loss, requirement for intraoperative or postoperative transfusions, and small bowel perforation as a source of peritonitis were associated with IH.
  
  
  CONCLUSIONS
  IH occurs quite frequently after surgery for secondary peritonitis. Preexisting risk factors for IH and intraoperative blood loss or requirement for blood transfusions were correlated with the development of IH. Interestingly, surgical technique was not correlated with the development of IH in this series.
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg, Germany.
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Moussavian
authors.forename: Jochen
authors.initials: J
authors.lastname: Schuld
authors.forename: Daniel
authors.initials: D
authors.lastname: Dauer
authors.forename: Christoph
authors.initials: C
authors.lastname: Justinger
authors.forename: Otto
authors.initials: O
authors.lastname: Kollmar
authors.forename: Martin K
authors.initials: MK
authors.lastname: Schilling
authors.forename: Sven
authors.initials: S
authors.lastname: Richter
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome