PDF(Pubmed)
Abstract：
Incisional hernia (IH) is a frequent complication following abdominal surgery. The development of IH could be more sophisticated than a simple anatomical failure of the abdominal wall. Reported IH incidence varies among studies. This review presented an overview of definitions, molecular basis, risk factors, incidence, clinical presentation, surgical techniques, postoperative care, cost, risk prediction tools, and proposed preventative measures. A literature search of PubMed was conducted to include high-quality studies on IH. The incidence of IH depends on the primary surgical pathology, incision site and extent, associated medical comorbidities, and risk factors. The review highlighted inherent and modifiable risk factors. The disorganisation of the extracellular matrix, defective fibroblast functions, and ratio variations of different collagen types are implicated in molecular mechanisms. Elective repair of IH alleviates symptoms, prevents complications, and improves the quality of life (QOL). Recent studies introduced risk prediction tools to implement preventative measures, including suture line reinforcement or prophylactic mesh application in high-risk groups. Elective repair improves QOL and prevents sinister outcomes associated with emergency IH repair. The watchful wait strategy should be reviewed, and options should be discussed thoroughly during patients\' counselling. Risk stratification tools for predicting IH would help adopt prophylactic measures.
摘要：
切口疝（IH）是腹部手术后的常见并发症。IH的发展可能比腹壁的简单解剖故障更复杂。报告的IH发病率因研究而异。这篇综述概述了定义，分子基础，危险因素，发病率,临床表现,外科技术,术后护理,成本,风险预测工具，并提出了预防措施。对PubMed进行了文献检索，以纳入关于IH的高质量研究。IH的发病率取决于原发性手术病理，切口部位和范围,相关的医疗合并症，和风险因素。审查强调了固有和可改变的风险因素。细胞外基质的解体，成纤维细胞功能缺陷,不同胶原蛋白类型的比例变化与分子机制有关。IH的选择性修复可缓解症状，预防并发症,并提高了生活质量（QOL）。最近的研究引入了风险预测工具来实施预防措施，包括缝合线加固或在高危人群中预防性应用网状物。选择性修复可改善QOL并防止与紧急IH修复相关的险恶结果。应该审查警惕的等待策略，在患者咨询期间，应彻底讨论各种选择。用于预测IH的风险分层工具将有助于采取预防措施。
