Page 91 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Objective
The objective is to provide guidelines for all surgical specialists who perform abdominal incisions in adult patients on the optimal materials and methods used to close the abdominal wall. The goal is to decrease the occurrence of both burst abdomen and incisional hernia. The guidelines refer to patients undergoing any kind of abdominal wall incision, including visceral surgery, gynaecological surgery, aortic vascular surgery, urological surgery or orthopaedic surgery. Both open and laparoscopic surgeries are included in these guidelines.
Methods
As EHS secretary of Quality, Filip Muysoms, under the auspices of the European Hernia Society board, proposed the Guidelines Development Group. The project was presented to the EHS board and accepted during the board meeting in Sperlonga, Italy, on September 28th 2013. The members of the Guidelines Development Group were chosen to recruit key opinion leaders and researchers on the subject from Europe. A geographical distribution across European countries was attempted and some younger surgeons having performed research on the subject were included in the Guidelines Development Group. Many of the members have contributed previously in producing guidelines on a national and international level. The Guidelines Development Group included abdominal wall surgeons, upper gastro-intestinal surgeons, hepato- biliary surgeons, colorectal surgeons and a vascular surgeon.
During a Kick O meeting of the Guidelines Development Group in the Bonham Hotel in Edinburgh on October 28th 2013, the members attended a seminar on the methodological aspect of developing guidelines by Robin T Harbour, the Lead Methodologist of the Scottish Intercollegiate Guidelines Network (SIGN)(19). The AGREE II instrument was used from the start of the project to guide our methodology and structure of producing the guidelines(20). AGREE II gives as de nition for the Quality of a guideline: “The con dence that the potential biases of guideline development have been addressed adequately and that the recommendations are both internally and externally valid, and are feasible for practice.” During this rst meeting Key Questions were formulated and translated into 24 patients-intervention-
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EHS guidelines
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