Table 5 Risk factors for incisional hernia development after posterior CS with TAR reinforced by retro muscular mesh (n = 202)
Incisional hernia | P-value | ||
|---|---|---|---|
Yes (n = 18) N (%) | No (n = 184) N (%) | ||
Age (years) (Mean ± SD) | 55 ± 9 | 41 ± 9 | < 0.001* |
Gender | |||
Males | 12 (66.7%) | 69 (37.5%) | 0.016* |
Females | 6 (33.3%) | 115 (62.5%) | |
Body mass index (Mean ± SD) | 35 ± 3 | 34 ± 4 | 0.081 |
ASA | |||
I | 10 (55.6%) | 130 (70.7%) | |
II | 4 (22.2%) | 37 (20.1%) | 0.201 |
III | 4 (22.2%) | 17 (9.2%) | |
Diabetes mellitus | 6 (33.3%) | 38 (20.7%) | 0.213 |
Hypertension | 6 (33.3%) | 35 (19.0%) | 0.15 |
COPD | 3 (16.7%) | 17 (9.2%) | 0.314 |
Smoking | 15 (83.3%) | 31 (16.8%) | < 0.001* |
Steroid intake | 1 (5.6%) | 9 (4.9%) | 0.901 |
Family history of any previous hernia | 1 (5.6%) | 30 (16.3%) | 0.227 |
Time from index surgeries (midline laparotomies) till occurrence of primary AWD (days) (Mean ± SD) | 6 ± 2 | 7 ± 3 | 0.312 |
Albumin level < 3.5 gm% | 16 (88.9%) | 30 (16.3%) | < 0.001* |
Site of AWD | |||
Infra umbilical | 3 (16.7%) | 35 (19.0%) | |
Supra umbilical | 8 (44.4%) | 49 (26.6%) | 0.268 |
Umbilical | 7 (38.9%) | 100 (54.3%) | |
Previous midline laparotomies | |||
Emergent | 13 (72.2%) | 133 (72.3%) | 0.996 |
Elective | 5 (27.8%) | 51 (27.7%) | |
Specialty | |||
General & GIT | 12 (66.7%) | 139 (75.5%) | |
Gynecology | 4 (22.2%) | 32 (17.4%) | 0.76 |
Vascular | 2 (11.1%) | 13 (7.1%) | |
Possible etiology of AWD | |||
Fascial necrosis | 0 (0.0%) | 10 (5.4%) | |
Infection | 3 (16.7%) | 26 (14.1%) | |
Loose knot | 2 (11.1%) | 3 (1.6%) | NA |
Cut through suture | 12 (66.7%) | 79 (42.9%) | |
Unknown | 1 (5.6%) | 66 (35.9%) | |
Time from primary AWD to posterior CS + TAR surgery (days) (Mean ± SD) | 5 ± 2 | 3 ± 1 | < 0.001* |
Operative time of posterior CS + TAR (minute) (Mean ± SD) | 91 ± 10 | 95 ± 13 | 0.228 |
Blood loss > 500 ml | 4 (22.2%) | 37 (20.1%) | 0.832 |
Blood transfusion (units) | 4 (22.2%) | 38 (20.7%) | 0.876 |
Primary AWD vertical length (cm) (Mean ± SD) | 16 ± 2 | 16 ± 3 | 0.746 |
Primary AWD horizontal length (cm) (Mean ± SD) | 13 ± 3 | 12 ± 3 | 0.294 |
Hospital stay (days)(Mean ± SD) | 12 ± 1 | 12 ± 1 | 0.682 |
ICU admission (days) | 1 (5.6%) | 19 (10.3%) | 0.518 |
Surgical site infection | 11 (61.1%) | 5 (2.7%) | < 0.001* |
Ileus | 7 (38.9%) | 2 (1.1%) | < 0.001* |
Infected mesh | 5 (27.8%) | 1 (0.5%) | < 0.001* |