Page 18 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 1
In the rst part, studies are presented on the current incidence of IH, and on the best surgical technique to prevent it.
In Chapters 2 and 3, the in uence of exact suture techniques on the incidence of IH is examined. These chapters present the design (Chapter 2) and outcomes (Chapter 3) of a randomized controlled trial (RCT) comparing a commonly used ‘large bites’ technique (large tissue bites of at least a centimetre, with a stitch placed every centimetre) with a promising ‘small bites’ technique (small tissue bites of half a centimetre, with a stitch placed every half centimetre).
In Chapter 4, there is presentation of a systematic review and meta-analysis to evaluate the evidence from published RCTs examining suture materials or suture techniques on the incidence of IH.
In Chapter 5, the available evidence on the optimal materials and methods used to close abdominal wall incisions is used to report on European Hernia Society (EHS) guidelines.
In Chapter 6, a cross-sectional study on the incidence of IH and PSH in 150 patients with end-colostomy and midline laparotomy, is presented.
In Chapter 7, the aetiology of the combination of IH and PSH is further investigated. The e ect of damage to the intercostal nerves due to herniation after colostomy formation with subsequent rectus atrophy and midline shift, is examined.
In the second part of this thesis, studies are presented on the surgical treatment of IH.
In Chapter 8, the results of a systematic review conducted to identify the best possible technique(s) for large IH repair, with regard to recurrence and complication rates, is reported on.
In Chapter 9, the EHS recommendations for abdominal wall surgery, for describing hernia variables, treatment variables, and for reporting outcomes, are presented.
In Chapter 10, several synthetic and biological meshes are compared in an animal experiment on adhesion formation and incorporation during long-term follow-up.
In Chapter 11, an animal experiment is described in which several synthetic and collagen meshes are implanted in a contaminated environment, and mesh infection and adhesion formation are evaluated.
In Chapter 12, the mesh-speci c cellular responses are described.
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