Lacing technique using dermal autografts for the management of large incisional hernias

Between 1980 and 1990, 25 patients were treated for large incisional hernias using the skin lacing technique. Twenty-four hernias were midline and one was at the site of a McBurney incision. Hernia defects were greater than 10 cm in diameter for 24 patients. A 1 cm-wide uninterrupted segment of skin was harvested from excess skin overlying the hernia and was then alternatively passed through the left and right fascial margins of the hernia. The operative mortality was nil. Two wound abscesses were drained locally and did not mandate removal of the skin lace. After a mean follow-up of 4.9 years, 3 recurrences were observed. Among 22 patients who had a successful repair of their incisional hernia, 20 returned to their previous occupations and two others reported improvement in performing their daily tasks. The skin lacing technique is an interesting alternative to other more sophisticated techniques in the management of large incisional hernias.