Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study
Kevin N. Harrell, University of Tennessee College of Medicine Chattanooga, 979 E 3rd Street Suite B 401, Chattanooga, TN, 37403, USA. Electronic address: kevinharrell830@gmail.com.
Arthur D. Grimes, University of Oklahoma, 800 Stanton L. Young Blvd #9000, Oklahoma City, OK, 73104, USA. Electronic address: adgrimes@wakehealth.edu.
Harkanwar Gill, University of Oklahoma, 800 Stanton L. Young Blvd #9000, Oklahoma City, OK, 73104, USA. Electronic address: gillha@musc.edu.
Jessica K. Reynolds, University of Kentucky School of Medicine, 800 Rose St, MN268A, Lexington, KY, 40536, USA. Electronic address: JessicaK.Reynolds@uky.edu.
Walker R. Ueland, University of Kentucky School of Medicine, 800 Rose St, MN268A, Lexington, KY, 40536, USA. Electronic address: wueland@ufl.edu.
Jason D. Sciarretta, Grady Health System, 80 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA. Electronic address: jason.d.sciarretta@emory.edu.
Samual R. Todd, Grady Health System, 80 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA. Electronic address: srtodd@gmh.edu.
Marc D. Trust, University of Texas at Austin, 1501 Red River St, Austin, TX, 78712, USA. Electronic address: mdtrust@ascension.org.
Marielle Ngoue, University of Texas at Austin, 1501 Red River St, Austin, TX, 78712, USA. Electronic address: mariellen@utexas.edu.
Bradley W. Thomas, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA. Electronic address: Bradley.thomas@atriumhealth.org.
Sullivan A. Ayuso, Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA. Electronic address: sullivan.ayuso@atriumhealth.org.
Aimee LaRiccia, Grant Medical Center, 111 S Grant Ave, Columbus, OH, 43215, USA. Electronic address: aimee.lariccia@ohiohealth.com.
Abstract
BACKGROUND: Few studies have investigated risk factors for recurrence of blunt traumatic abdominal wall hernias (TAWH). METHODS: Twenty trauma centers identified repaired TAWH from January 2012 to December 2018. Logistic regression was used to investigate risk factors for recurrence. RESULTS: TAWH were repaired in 175 patients with 21 (12.0%) known recurrences. No difference was found in location, defect size, or median time to repair between the recurrence and non-recurrence groups. Mesh use was not protective of recurrence. Female sex, injury severity score (ISS), emergency laparotomy (EL), and bowel resection were associated with hernia recurrence. Bowel resection remained significant in a multivariable model. CONCLUSION: Female sex, ISS, EL, and bowel resection were identified as risk factors for hernia recurrence. Mesh use and time to repair were not associated with recurrence. Surgeons should be mindful of these risk factors but could attempt acute repair in the setting of appropriate physiologic parameters.
