Page 34 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 2
Outpatient clinic follow up
• Outpatient clinic visit at 1 and 12 months o Incisional hernia
o Wound infection
o Seroma formation
o Other wound problems
o Other abdominal wall hernia
• Ultrasound at 1 and 12 months
• VAS pain scores and Quality of Life forms preoperatively (day of
operation or the day before) and at 1,3, 6 and 12 months
Ultrasound examinations
During the 1 month and 1 year follow up an ultra sound examination will be performed to measure the distance between the rectus muscles at 3 point in the incision and control for incisional hernia. A speci c score is used for the ultrasound examination. At ten points, which include 4 measurements of the distance between the rectus muscle, the quality of the scar in the abdominal wall is objecti ed. With this method the conclusion if there is an incisional hernia can also be made on the score list. In this list is controlled for:
• An intact linea alba?
• Bulging without Valsalva maneuver?
• Bulging with Valsalva maneuver?
• Distance between rectus muscles in scar on 1/3 cranial part in cm?
• Distance between rectus muscles in scar on 1/3 caudal part in cm?
• Maximum distance between rectus muscles in scar in cm?
• Maximum distance between rectus muscles at place of bulging or
defect in cm?
• Is there a defect? If yes, the size of the defect and location
• Is there fatty tissue in the defect?
• Is there a bowel loop in the defect?
The radiologist is asked to make prints of every measurement and nding.
Quality of life will be assessed based on standardized Quality of Life forms including the EuroQol-5D and Short Form-36 before and at 1 month, 3 months, 6 months, and 12 months after surgery.
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