Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Aug 2;16(1):50.
doi: 10.1186/s12893-016-0166-x.

Giant ventral hernia-relationship between abdominal wall muscle strength and hernia area

K Strigård  1 , L Clay  2 , B Stark  3 , U Gunnarsson  4 , P Falk  5
Affiliations
Randomized Controlled Trial

Giant ventral hernia-relationship between abdominal wall muscle strength and hernia area

K Strigård et al. BMC Surg. .

Abstract

Background: Symptoms arising from giant ventral hernia have been considered to be related to weakening of the abdominal muscles. The aim of this study was to investigate the relationship between the area of the abdominal wall defect and abdominal wall muscle strength measured by the validated BioDex system together with a back/abdominal unit.

Methods: Fifty-two patients with giant ventral hernia (>10 cm wide) underwent CT scan, clinical measurement of hernia size and BioDex measurement of muscle strength prior to surgery. The areas of the hernia derived from CT scan and from clinical measurement were compared with BioDex forces in the modalities extension, flexion and isometric contraction. The Spearman rank test was used to calculate correlations between area, BMI, gender, age, and muscle strength.

Result: The hernia area calculated from clinical measurements correlated to abdominal muscle strength measured with the Biodex for all modalities (p-values 0.015-0.036), whereas no correlation was seen with the area calculated by CT scan. No relationship was seen between BMI, gender, age and the area of the hernia.

Discussion: The inverse correlation between BioDex abdominal muscle strength and clinically assessed hernia area, seen in all modalities, was so robust that it seems safe to conclude that the area of the hernia is an important determinant of the degree of loss of abdominal muscle strength. Results using hernia area calculated from the CT scan showed no such correlation and this would seem to concur with the results from a previous study by our group on patients with abdominal rectus diastasis. In that study, defect size assessed clinically, but not that measured by CT scan, was in agreement with the size of the diastasis measured intra-operatively. The point at which the area of a hernia begins to correlate with loss of abdominal wall muscle strength remains unknown since this study only included giant ventral hernias.

Keywords: Abdominal muscle strength; Biodex; Giant ventral hernia; Hernia area.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
BioDex, System 4 with the back/abdominal unit. Member of the staff demonstrating Biodex. The patient is strapped in a fixed position. This prevents using other muscles than the abdominal corset and makes it possible to perform tests that are reproducible at a later stage
Fig. 2
Fig. 2
Scatterplot for 52 patients showing distribution of force in Nm generated at flexion 30o/s versus hernia area from clinical measurement in cm2
Fig. 3
Fig. 3
Scatterplot for 52 patients showing distribution of force in Nm generated at extension 30o/s versus hernia area from CT scan in cm2
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Luijendijk RW, Lemmen MH, Hop WC, Wereldsma JC. Incisional hernia recurrence following “vest-over-pants” or vertical Mayo repair of primary hernias of the midline. World J Surg. 1997;21(1):62–5. doi: 10.1007/s002689900194. - DOI - PubMed
    1. Goodenough CJ, Ko TC, Kao LS, Nguyen MT, Holihan JL, Alawadi Z, Nguyen DH, Flores JR, Arita NT, Roth JS, Liang MK. Development and validation of a risk stratification score for ventral incisional hernia after abdominal surgery: hernia expectation rates in intra-abdominal surgery (the HERNIA Project) J Am Coll Surg. 2015;220(4):405–13. doi: 10.1016/j.jamcollsurg.2014.12.027. - DOI - PMC - PubMed
    1. Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B. Collagen I/III and matrix metalloproteinases (MMP) 1 and 13 in the fascia of patients with incisional hernias. J Invest Surg. 2001;14(1):47-54. - PubMed
    1. Mingoli A, Puggioni A, Sgarzini G, Luciani G, Corzani F, Ciccarone F, Baldassarre E, Modini C. Incidence of incisional hernia following emergency abdominal surgery. Ital J Gastroenterol Hepatol. 1999;31(6):449–53. - PubMed
    1. Chung L, O’Dwyer PJ. Pain and its effects on physical activity and quality of life before operation in patients undergoing elective inguinal and ventral hernia repair. Am J Surg. 2014;208(3):406–411001. doi: 10.1016/j.amjsurg.2014.02.011. - DOI - PubMed

Publication types

LinkOut - more resources