Comparison of Incisional Hernia Rates Between General and Gynecological Surgery Procedures

<i>Background and Objectives</i>: Incisional hernias are a common and costly complication of surgery, occurring in up to 20% of midline incisions within 3 years of initial operation. Risk factors for incisional hernia include incision site, fascial closure technique, body mass index (BMI...

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Main Authors: Krista Spear, Daniel L. Davenport, Lance Butler, Margaret Plymale, John Scott Roth
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/435
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author Krista Spear
Daniel L. Davenport
Lance Butler
Margaret Plymale
John Scott Roth
author_facet Krista Spear
Daniel L. Davenport
Lance Butler
Margaret Plymale
John Scott Roth
author_sort Krista Spear
collection DOAJ
description <i>Background and Objectives</i>: Incisional hernias are a common and costly complication of surgery, occurring in up to 20% of midline incisions within 3 years of initial operation. Risk factors for incisional hernia include incision site, fascial closure technique, body mass index (BMI), surgical site infections, and gastrointestinal surgery. Limited studies have compared procedural type as a risk factor for hernia formation. The goal of this study was to examine incisional hernia rates among general surgical and gynecologic procedures. <i>Materials and Methods</i>: We queried our Research Data Warehouse for inpatients who had undergone common open abdominal surgeries between January 2012 and December 2022. Patients’ index operations were identified based upon Current Procedural Terminology (CPT) codes and presence of a postoperative incisional hernia was determined by occurrence of an incisional hernia ICD10 diagnosis code more than 2 weeks postoperatively. The main study outcome was time to incisional hernia diagnosis. <i>Results</i>: A total of 4447 patients were identified. Postoperatively, 241 (5.4%) patients were diagnosed with incisional hernias. Hernia rates at 1, 3 and 5 years were 3% (SE 0.003), 6% (0.004) and 8% (0.005), respectively. Patients undergoing exploratory laparotomy (hazard ratio 3.9, <i>p</i> < 0.001), bowel resection (HR 5.5, <i>p</i> < 0.001), and primary hernia repair (HR 13.0, <i>p</i> < 0.001) were found to have significantly increased risk for incisional hernia development compared to those undergoing hysterectomy, following adjustment for comorbid risks, age, sex, and BMI. <i>Conclusions</i>: Exploratory laparotomy, bowel resection, and primary ventral hernia repair are associated with a higher incidence of incisional hernia relative to gynecologic procedures. This relatively unstudied comparison warrants further investigation.
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spelling doaj-art-079bfdf349014e2dbde00cfdcb13f7422025-08-20T02:11:08ZengMDPI AGMedicina1010-660X1648-91442025-02-0161343510.3390/medicina61030435Comparison of Incisional Hernia Rates Between General and Gynecological Surgery ProceduresKrista Spear0Daniel L. Davenport1Lance Butler2Margaret Plymale3John Scott Roth4College of Medicine, University of Kentucky, Lexington, KY 40536, USADivision of Healthcare Outcomes and Optimal Patient Services, Department of Surgery, University of Kentucky, Lexington, KY 40536, USADivision of Healthcare Outcomes and Optimal Patient Services, Department of Surgery, University of Kentucky, Lexington, KY 40536, USADivision of General, Endocrine, and Metabolic Surgery, Department of Surgery, University of Kentucky, Lexington, KY 40536, USADivision of General, Endocrine, and Metabolic Surgery, Department of Surgery, University of Kentucky, Lexington, KY 40536, USA<i>Background and Objectives</i>: Incisional hernias are a common and costly complication of surgery, occurring in up to 20% of midline incisions within 3 years of initial operation. Risk factors for incisional hernia include incision site, fascial closure technique, body mass index (BMI), surgical site infections, and gastrointestinal surgery. Limited studies have compared procedural type as a risk factor for hernia formation. The goal of this study was to examine incisional hernia rates among general surgical and gynecologic procedures. <i>Materials and Methods</i>: We queried our Research Data Warehouse for inpatients who had undergone common open abdominal surgeries between January 2012 and December 2022. Patients’ index operations were identified based upon Current Procedural Terminology (CPT) codes and presence of a postoperative incisional hernia was determined by occurrence of an incisional hernia ICD10 diagnosis code more than 2 weeks postoperatively. The main study outcome was time to incisional hernia diagnosis. <i>Results</i>: A total of 4447 patients were identified. Postoperatively, 241 (5.4%) patients were diagnosed with incisional hernias. Hernia rates at 1, 3 and 5 years were 3% (SE 0.003), 6% (0.004) and 8% (0.005), respectively. Patients undergoing exploratory laparotomy (hazard ratio 3.9, <i>p</i> < 0.001), bowel resection (HR 5.5, <i>p</i> < 0.001), and primary hernia repair (HR 13.0, <i>p</i> < 0.001) were found to have significantly increased risk for incisional hernia development compared to those undergoing hysterectomy, following adjustment for comorbid risks, age, sex, and BMI. <i>Conclusions</i>: Exploratory laparotomy, bowel resection, and primary ventral hernia repair are associated with a higher incidence of incisional hernia relative to gynecologic procedures. This relatively unstudied comparison warrants further investigation.https://www.mdpi.com/1648-9144/61/3/435herniaincisional herniahernia rate comparisongynecological surgerygeneral surgery
spellingShingle Krista Spear
Daniel L. Davenport
Lance Butler
Margaret Plymale
John Scott Roth
Comparison of Incisional Hernia Rates Between General and Gynecological Surgery Procedures
Medicina
hernia
incisional hernia
hernia rate comparison
gynecological surgery
general surgery
title Comparison of Incisional Hernia Rates Between General and Gynecological Surgery Procedures
title_full Comparison of Incisional Hernia Rates Between General and Gynecological Surgery Procedures
title_fullStr Comparison of Incisional Hernia Rates Between General and Gynecological Surgery Procedures
title_full_unstemmed Comparison of Incisional Hernia Rates Between General and Gynecological Surgery Procedures
title_short Comparison of Incisional Hernia Rates Between General and Gynecological Surgery Procedures
title_sort comparison of incisional hernia rates between general and gynecological surgery procedures
topic hernia
incisional hernia
hernia rate comparison
gynecological surgery
general surgery
url https://www.mdpi.com/1648-9144/61/3/435
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AT lancebutler comparisonofincisionalherniaratesbetweengeneralandgynecologicalsurgeryprocedures
AT margaretplymale comparisonofincisionalherniaratesbetweengeneralandgynecologicalsurgeryprocedures
AT johnscottroth comparisonofincisionalherniaratesbetweengeneralandgynecologicalsurgeryprocedures