HERNIAS, AORTIC SURGERY AND REVIEW OF THE LITERATURE ON INCISIONAL HERNIAS Kile, kirurgija aorte i pregled literature incizijskih hernija

Objectives: To study the relation of incisional hernias after abdominal aortic surgery and to study the recommendations for prevention of incisional hernias in general. Methods: An extensive search in Pub-Med was conducted. We used the following MeSH terms; abdominal aortic aneurysm; incisional hernia; inguinal hernia; incisional hernia and radiology, abdominal wound closure, we also did a “snow-falling” search with the above terms. Results: Still today there is no unanimity concerning the relation of aortic or aortoiliac pathology and incisional or inguinal hernias although the majority of studies suggest that there is a possible increase in the prevalence of incisional hernias after aortic surgery. Conclusions: In order to lessen the possibilities of incisional hernias suture length to wound length ration should be more that 4:1. Sutures should be tied without excessive tension and either a slowly absorbable or nonabsorbable suture material should be used. Use a suture USP 2/0 mounted on a small needle. Place stitches in the aponeurosis only and 5 to 8 mm from the wound edge and 4 to 5 mm apart.