title: Wound Healing Following Open Groin Hernia Surgery: The Impact of Comorbidity.
abstract: BACKGROUND
  The aim of this study was to explore the impact of chronic concomitant disease on the risk for postoperative complications following open groin hernia surgery.
  
  
  METHODS
  During the study period (2002-2011), 133,074 open repairs were registered in the Swedish Hernia Register. History of peripheral vascular disorders, connective tissue disease, chronic renal failure, obesity, and liver cirrhosis as well as data on hemorrhage or hematoma, wound dehiscence, postoperative infection, and reoperation for superficial infection or bleeding within 30 days after surgery were obtained by matching with the Swedish Patient Register.
  
  
  RESULTS
  In the multivariate logistic regression analysis, a significantly increased risk for hemorrhage or hematoma within 30 days after surgery was seen for older patients, males, liver cirrhosis, peripheral vascular disease, and connective tissue disease (p < 0.05). High age (>80 years), previous history of peripheral vascular disease, connective tissue disease, and male gender were risk factors for wound dehiscence (p < 0.05). Liver cirrhosis, chronic kidney disease, BMI > 25, and male gender were associated with increased risk for postoperative wound infection (p < 0.05). A significantly increased risk for reoperation for superficial infection or bleeding was seen in patients with peripheral vascular disease and elderly patients (p < 0.05).
  
  
  CONCLUSIONS
  Risk for postoperative complications in open groin hernia surgery is increased in elderly patients, patients with liver cirrhosis, and those with peripheral vascular disease. The indications for surgery should be weighed against the risk for wound-healing complications in these patient groups. Watchful waiting may be an alternative, although this carries the risk of emergency surgery.
authors.affiliation: Department of Surgery, Capio St Göran Hospital, Stockholm, Sweden, victoriaruhling@gmail.com.
authors.forename: Victoria
authors.initials: V
authors.lastname: Rühling
authors.forename: Ulf
authors.initials: U
authors.lastname: Gunnarsson
authors.forename: Ursula
authors.initials: U
authors.lastname: Dahlstrand
authors.forename: Gabriel
authors.initials: G
authors.lastname: Sandblom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D014945:Wound Healing / Q000502:physiology*