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Incisional hernia repair: tensiometry for the selection of the appropriate procedure
B Reingruber1, S Kastl, C Stremmel
1University Department of Surgery, Erlangen, at the Friedrich-Alexander-University, Erlangen-Nürnberg, Germany.
Objective:
To audit the early and late results of repairs of incisional hernias before and after the introduction of peroperative tensiometry.
Design:
Retrospective study.
Setting:
University hospital, Germany.
Patients:
675 operations on 553 patients in 18 years.
Interventions:
Before we introduced tensiometry we closed 560 incisional hernias by direct suture and 63 by the inlay-onlay technique. Since we took up tensiometry the numbers were 9 and 43, respectively.
Main Outcome Measures:
Postoperative complications including recurrences.
Results:
Recurrences developed in 246/560 (44%) after direct suture in the early series, compared with 2/9 (22%) after adoption of tensiometry. After inlay-onlay operations there were 4/63 (6%) recurrences before, and 1/43 (2%) after adoption of tensiometry.
Conclusions:
Tensiometry allows the surgeon to tailor his operation to the conditions that he finds during the operation.