title: Early laparotomy wound failure as the mechanism for incisional hernia formation.
abstract: BACKGROUND
  Incisional hernia is the most common complication of abdominal surgery leading to reoperation. In the United States, 200,000 incisional hernia repairs are performed annually, often with significant morbidity. Obesity is increasing the risk of laparotomy wound failure.
  
  
  METHODS
  We used a validated animal model of incisional hernia formation. We intentionally induced laparotomy wound failure in otherwise normal adult, male Sprague-Dawley rats. Radio-opaque, metal surgical clips served as markers for the use of x-ray images to follow the progress of laparotomy wound failure. We confirmed radiographic findings of the time course for mechanical laparotomy wound failure by necropsy.
  
  
  RESULTS
  Noninvasive radiographic imaging predicts early laparotomy wound failure and incisional hernia formation. We confirmed both transverse and craniocaudad migration of radio-opaque markers at necropsy after 28 d that was uniformly associated with the clinical development of incisional hernias.
  
  
  CONCLUSIONS
  Early laparotomy wound failure is a primary mechanism for incisional hernia formation. A noninvasive radiographic method for studying laparotomy wound healing may help design clinical trials to prevent and treat this common general surgical complication.
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109, USA. liyuxing@umich.edu
authors.forename: Liyu
authors.initials: L
authors.lastname: Xing
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Culbertson
authors.forename: Yuan
authors.initials: Y
authors.lastname: Wen
authors.forename: Michael G
authors.initials: MG
authors.lastname: Franz
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D046449:Hernia, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D013902:Radiography, Thoracic; D051381:Rats; D017207:Rats, Sprague-Dawley; D013525:Surgical Instruments; D013529:Surgical Wound Dehiscence / Q000150:complications* / Q000503:physiopathology; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology