Abstract：
BACKGROUND: Blunt traumatic abdominal wall hernias (TAWHs) are rare but require a variety of operative techniques to repair including bone anchor fixation (BAF) when tissue tears off bony structures. This study aimed to provide a descriptive analysis of BAF technique for blunt TAWH repair. Bone anchor fixation and no BAF repairs were compared, hypothesizing increased hernia recurrence with BAF repair.
METHODS: A secondary analysis of the WTA blunt TAWH multicenter study was performed including all patients who underwent repair of their TAWH. Patients with BAF were compared to those with no BAF with bivariate analyses.
RESULTS: 176 patients underwent repair of their TAWH with 41 (23.3%) undergoing BAF. 26 (63.4%) patients had tissue fixed to bone, with 7 of those reinforced with mesh. The remaining 15 (36.6%) patients had bridging mesh anchored to bone. The BAF group had a similar age, sex, body mass index, and injury severity score compared to the no BAF group. The time to repair (1 vs 1 days, P = .158), rate of hernia recurrence (9.8% vs 12.7%, P = .786), and surgical site infection (SSI) (12.5% vs 15.6%, P = .823) were all similar between cohorts.
CONCLUSIONS: This largest series to date found nearly one-quarter of TAWH repairs required BAF. Bone anchor fixation repairs had a similar rate of hernia recurrence and SSI compared to no BAF repairs, suggesting this is a reasonable option for repair of TAWH. However, future prospective studies are needed to compare specific BAF techniques and evaluate long-term outcomes including patient-centered outcomes such as pain and quality of life.
METHODS: A secondary analysis of the WTA blunt TAWH multicenter study was performed including all patients who underwent repair of their TAWH. Patients with BAF were compared to those with no BAF with bivariate analyses.
RESULTS: 176 patients underwent repair of their TAWH with 41 (23.3%) undergoing BAF. 26 (63.4%) patients had tissue fixed to bone, with 7 of those reinforced with mesh. The remaining 15 (36.6%) patients had bridging mesh anchored to bone. The BAF group had a similar age, sex, body mass index, and injury severity score compared to the no BAF group. The time to repair (1 vs 1 days, P = .158), rate of hernia recurrence (9.8% vs 12.7%, P = .786), and surgical site infection (SSI) (12.5% vs 15.6%, P = .823) were all similar between cohorts.
CONCLUSIONS: This largest series to date found nearly one-quarter of TAWH repairs required BAF. Bone anchor fixation repairs had a similar rate of hernia recurrence and SSI compared to no BAF repairs, suggesting this is a reasonable option for repair of TAWH. However, future prospective studies are needed to compare specific BAF techniques and evaluate long-term outcomes including patient-centered outcomes such as pain and quality of life.
摘要：
背景：钝性外伤性腹壁疝（TAUHs）是罕见的，但需要多种手术技术来修复，包括骨锚固定（BAF）时组织撕裂骨结构。本研究旨在对BAF技术用于钝性TAWH修复提供描述性分析。骨锚固定与无BAF修复进行比较,假设BAF修补术增加了疝复发。
方法：对WTA钝器TAWH多中心研究进行二次分析，包括所有接受TAWH修复的患者。使用双变量分析将患有BAF的患者与没有BAF的患者进行比较。
结果：176例患者接受了TAWH修复，其中41例（23.3％）接受了BAF。26例（63.4%）患者的组织固定在骨头上，其中7个用网眼加固。其余15名（36.6％）患者的桥接网固定在骨骼上。BAF组的年龄相似，性别,身体质量指数,与无BAF组相比，损伤严重程度评分。修复时间（1vs1天，P=.158），疝复发率（9.8％vs12.7％，P=.786），手术部位感染（SSI）（12.5%vs15.6%，P=.823）在队列之间都相似。
结论：迄今为止最大的系列发现近四分之一的TAWH维修需要BAF。与无BAF修复相比，骨锚固定修复的疝复发率和SSI率相似。这表明这是修复TAWH的合理选择。然而,未来的前瞻性研究需要比较特定的BAF技术,并评估长期结局,包括以患者为中心的结局,如疼痛和生活质量.
方法：对WTA钝器TAWH多中心研究进行二次分析，包括所有接受TAWH修复的患者。使用双变量分析将患有BAF的患者与没有BAF的患者进行比较。
结果：176例患者接受了TAWH修复，其中41例（23.3％）接受了BAF。26例（63.4%）患者的组织固定在骨头上，其中7个用网眼加固。其余15名（36.6％）患者的桥接网固定在骨骼上。BAF组的年龄相似，性别,身体质量指数,与无BAF组相比，损伤严重程度评分。修复时间（1vs1天，P=.158），疝复发率（9.8％vs12.7％，P=.786），手术部位感染（SSI）（12.5%vs15.6%，P=.823）在队列之间都相似。
结论：迄今为止最大的系列发现近四分之一的TAWH维修需要BAF。与无BAF修复相比，骨锚固定修复的疝复发率和SSI率相似。这表明这是修复TAWH的合理选择。然而,未来的前瞻性研究需要比较特定的BAF技术,并评估长期结局,包括以患者为中心的结局,如疼痛和生活质量.
