Page 32 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 2
Outcome parameters
Primary outcome
• Primary outcome will be incisional hernia occurrence within one year after surgery, either clinically and/or ultrasonographically detected.
Secondary outcome
• Postoperative complications
• Pain
• Quality of life
• Cost e ectiveness
We use the de nition of the incisional hernia by the European Hernia Society: ‘any abdominal wall gap with or without bulge in the area of a postoperative scar perceptible or palpable by clinical examination or imaging’. The classi cation made by the European Hernia Society is used. [35] The classi cation of incisional hernias: Incisional hernias will be classi ed according to their localization, size, reducibility and symptoms.
Discharge dates and complications will be registered. Patients who fail to keep their annual clinic appointment will be given the option of a further appointment at a more suitable date or a visit to their home if they cannot make it to the outpatient clinic. The following data will be gathered at di erent points in time:
Preoperative data
• Date of birth
• Length and weight
• Current smoker (Yes or No).
• Medical history (including chronic obstructive pulmonary disease
(COPD), diabetes mellitus, cardiac disease, prior laparotomies)
• Preoperative radiotherapy or chemotherapy
• Preoperative or perioperative corticosteroids
• Previous abdominal operations
• Other abdominal wall hernias
• American Society of Anaesthesiologists (ASA) classi cation
• Width of linea alba (if preoperative Computed Tomography Imaging
is available) 30