Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Kevin N Harrell¹, Arthur D Grimes², Harkanwar Gill³, Jessica K Reynolds⁴, Walker R Ueland⁵, Jason D Sciarretta⁶, Samual R Todd⁷, Marc D Trust⁸, Marielle Ngoue⁹, Bradley W Thomas¹⁰, Sullivan A Ayuso¹¹, Aimee LaRiccia¹², M Chance Spalding¹³, Michael J Collins¹⁴, Bryan R Collier¹⁵, Basil S Karam¹⁶, Marc A de Moya¹⁷, Mark J Lieser¹⁸, John M Chipko¹⁹, James M Haan²⁰, Kelly L Lightwine²¹, Daniel C Cullinane²², Carolyne R Falank²³, Ryan C Phillips²⁴, Michael T Kemp²⁵, Hasan B Alam²⁶, Pascal O Udekwu²⁷, Gloria D Sanin²⁸, Amy N Hildreth²⁹, Walter L Biffl³⁰, Kathryn B Schaffer³¹, Gary Marshall³², Omaer Muttalib³³, Jeffry Nahmias³⁴, Niti Shahi³⁵, Steven L Moulton³⁶, Robert A Maxwell³⁷

Affiliations

¹ University of Tennessee College of Medicine Chattanooga, 979 E 3rd Street Suite B 401, Chattanooga, TN, 37403, USA. Electronic address: kevinharrell830@gmail.com.
² University of Oklahoma, 800 Stanton L. Young Blvd #9000, Oklahoma City, OK, 73104, USA. Electronic address: adgrimes@wakehealth.edu.
³ University of Oklahoma, 800 Stanton L. Young Blvd #9000, Oklahoma City, OK, 73104, USA. Electronic address: gillha@musc.edu.
⁴ University of Kentucky School of Medicine, 800 Rose St, MN268A, Lexington, KY, 40536, USA. Electronic address: JessicaK.Reynolds@uky.edu.
⁵ University of Kentucky School of Medicine, 800 Rose St, MN268A, Lexington, KY, 40536, USA. Electronic address: wueland@ufl.edu.
⁶ Grady Health System, 80 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA. Electronic address: jason.d.sciarretta@emory.edu.
⁷ Grady Health System, 80 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA. Electronic address: srtodd@gmh.edu.
⁸ University of Texas at Austin, 1501 Red River St, Austin, TX, 78712, USA. Electronic address: mdtrust@ascension.org.
⁹ University of Texas at Austin, 1501 Red River St, Austin, TX, 78712, USA. Electronic address: mariellen@utexas.edu.
¹⁰ Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA. Electronic address: Bradley.thomas@atriumhealth.org.
¹¹ Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA. Electronic address: sullivan.ayuso@atriumhealth.org.
¹² Grant Medical Center, 111 S Grant Ave, Columbus, OH, 43215, USA. Electronic address: aimee.lariccia@ohiohealth.com.
¹³ Grant Medical Center, 111 S Grant Ave, Columbus, OH, 43215, USA. Electronic address: chance.spalding@ohiohealth.com.
¹⁴ Carilion Clinic, 1906 Belleview Ave SE, Roanoke, VA, 24014, USA. Electronic address: mcoll1207@gmail.com.
¹⁵ Carilion Clinic, 1906 Belleview Ave SE, Roanoke, VA, 24014, USA. Electronic address: brcollier@carilionclinic.org.
¹⁶ Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA. Electronic address: basil.karam@gmail.com.
¹⁷ Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA. Electronic address: mdemoya@mcw.edu.
¹⁸ Research Medical Center, 2316 E Meyer Blvd, Kansas City, MO, 64132, USA. Electronic address: Mark.Lieser@extanthealthcare.com.
¹⁹ Research Medical Center, 2316 E Meyer Blvd, Kansas City, MO, 64132, USA. Electronic address: john.chipko@extanthealthcare.com.
²⁰ Ascension Via Christi on St. Francis Hospital, 929 St Francis, Wichita, KS, 67214, USA. Electronic address: james.haan.research@via-christi.org.
²¹ Ascension Via Christi on St. Francis Hospital, 929 St Francis, Wichita, KS, 67214, USA. Electronic address: kelly.lightwine@ascension.org.
²² Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA. Electronic address: Dcullinane@mmc.org.
²³ Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA. Electronic address: Cfalank@mmc.org.
²⁴ Denver Health Medical Center, 777 Bannock St, Denver, CO, 80204, USA. Electronic address: ryanphillips4848@gmail.com.
²⁵ University of Michigan, 1500 E Medical Center Dr Ann Arbor, MI, 48109, USA. Electronic address: mikemp@med.umich.edu.
²⁶ University of Michigan, 1500 E Medical Center Dr Ann Arbor, MI, 48109, USA. Electronic address: hasan.alam@nm.org.
²⁷ WakeMed Health, 3000 New Bern Ave, Raleigh, NC, 27610, USA. Electronic address: oudekwu@wakemed.org.
²⁸ Wake Forest School of Medicine, 1 Medical Center Blvd Winston-Salem, NC, 27157, USA. Electronic address: gsanin@wakehealth.edu.
²⁹ Wake Forest School of Medicine, 1 Medical Center Blvd Winston-Salem, NC, 27157, USA. Electronic address: ahildret@wakehealth.edu.
³⁰ Scripps Memorial Hospital La Jolla, 9888 Genesee Ave, La Jolla, CA, 92037, USA. Electronic address: Biffl.Walter@scrippshealth.org.
³¹ Scripps Memorial Hospital La Jolla, 9888 Genesee Ave, La Jolla, CA, 92037, USA. Electronic address: Kathryn.schaffer@sharp.com.
³² Medical City Plano Hospital, 3901 W 15th St, Plano, TX, 75075, USA. Electronic address: gary.marshall@envisionhealth.com.
³³ University of California, Irvine, 101 The City Dr S Orange, CA, 92868, USA. Electronic address: omuttali@hs.uci.edu.
³⁴ University of California, Irvine, 101 The City Dr S Orange, CA, 92868, USA. Electronic address: jnahmias1@yahoo.com.
³⁵ Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO, 80045, USA. Electronic address: niti.Shahi@umassmemorial.org.
³⁶ Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO, 80045, USA. Electronic address: Steven.Moulton@childrenscolorado.org.
³⁷ University of Tennessee College of Medicine Chattanooga, 979 E 3rd Street Suite B 401, Chattanooga, TN, 37403, USA. Electronic address: robert.maxwell@universitysurgical.com.

PMID: 36509587
DOI: 10.1016/j.amjsurg.2022.12.006

Multicenter Study

Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Kevin N Harrell et al. Am J Surg. 2023 Jun.

. 2023 Jun;225(6):1069-1073.

doi: 10.1016/j.amjsurg.2022.12.006. Epub 2022 Dec 7.

Authors

Affiliations

¹ University of Tennessee College of Medicine Chattanooga, 979 E 3rd Street Suite B 401, Chattanooga, TN, 37403, USA. Electronic address: kevinharrell830@gmail.com.
² University of Oklahoma, 800 Stanton L. Young Blvd #9000, Oklahoma City, OK, 73104, USA. Electronic address: adgrimes@wakehealth.edu.
³ University of Oklahoma, 800 Stanton L. Young Blvd #9000, Oklahoma City, OK, 73104, USA. Electronic address: gillha@musc.edu.
⁴ University of Kentucky School of Medicine, 800 Rose St, MN268A, Lexington, KY, 40536, USA. Electronic address: JessicaK.Reynolds@uky.edu.
⁵ University of Kentucky School of Medicine, 800 Rose St, MN268A, Lexington, KY, 40536, USA. Electronic address: wueland@ufl.edu.
⁶ Grady Health System, 80 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA. Electronic address: jason.d.sciarretta@emory.edu.
⁷ Grady Health System, 80 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA. Electronic address: srtodd@gmh.edu.
⁸ University of Texas at Austin, 1501 Red River St, Austin, TX, 78712, USA. Electronic address: mdtrust@ascension.org.
⁹ University of Texas at Austin, 1501 Red River St, Austin, TX, 78712, USA. Electronic address: mariellen@utexas.edu.
¹⁰ Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA. Electronic address: Bradley.thomas@atriumhealth.org.
¹¹ Atrium Health Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA. Electronic address: sullivan.ayuso@atriumhealth.org.
¹² Grant Medical Center, 111 S Grant Ave, Columbus, OH, 43215, USA. Electronic address: aimee.lariccia@ohiohealth.com.
¹³ Grant Medical Center, 111 S Grant Ave, Columbus, OH, 43215, USA. Electronic address: chance.spalding@ohiohealth.com.
¹⁴ Carilion Clinic, 1906 Belleview Ave SE, Roanoke, VA, 24014, USA. Electronic address: mcoll1207@gmail.com.
¹⁵ Carilion Clinic, 1906 Belleview Ave SE, Roanoke, VA, 24014, USA. Electronic address: brcollier@carilionclinic.org.
¹⁶ Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA. Electronic address: basil.karam@gmail.com.
¹⁷ Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA. Electronic address: mdemoya@mcw.edu.
¹⁸ Research Medical Center, 2316 E Meyer Blvd, Kansas City, MO, 64132, USA. Electronic address: Mark.Lieser@extanthealthcare.com.
¹⁹ Research Medical Center, 2316 E Meyer Blvd, Kansas City, MO, 64132, USA. Electronic address: john.chipko@extanthealthcare.com.
²⁰ Ascension Via Christi on St. Francis Hospital, 929 St Francis, Wichita, KS, 67214, USA. Electronic address: james.haan.research@via-christi.org.
²¹ Ascension Via Christi on St. Francis Hospital, 929 St Francis, Wichita, KS, 67214, USA. Electronic address: kelly.lightwine@ascension.org.
²² Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA. Electronic address: Dcullinane@mmc.org.
²³ Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA. Electronic address: Cfalank@mmc.org.
²⁴ Denver Health Medical Center, 777 Bannock St, Denver, CO, 80204, USA. Electronic address: ryanphillips4848@gmail.com.
²⁵ University of Michigan, 1500 E Medical Center Dr Ann Arbor, MI, 48109, USA. Electronic address: mikemp@med.umich.edu.
²⁶ University of Michigan, 1500 E Medical Center Dr Ann Arbor, MI, 48109, USA. Electronic address: hasan.alam@nm.org.
²⁷ WakeMed Health, 3000 New Bern Ave, Raleigh, NC, 27610, USA. Electronic address: oudekwu@wakemed.org.
²⁸ Wake Forest School of Medicine, 1 Medical Center Blvd Winston-Salem, NC, 27157, USA. Electronic address: gsanin@wakehealth.edu.
²⁹ Wake Forest School of Medicine, 1 Medical Center Blvd Winston-Salem, NC, 27157, USA. Electronic address: ahildret@wakehealth.edu.
³⁰ Scripps Memorial Hospital La Jolla, 9888 Genesee Ave, La Jolla, CA, 92037, USA. Electronic address: Biffl.Walter@scrippshealth.org.
³¹ Scripps Memorial Hospital La Jolla, 9888 Genesee Ave, La Jolla, CA, 92037, USA. Electronic address: Kathryn.schaffer@sharp.com.
³² Medical City Plano Hospital, 3901 W 15th St, Plano, TX, 75075, USA. Electronic address: gary.marshall@envisionhealth.com.
³³ University of California, Irvine, 101 The City Dr S Orange, CA, 92868, USA. Electronic address: omuttali@hs.uci.edu.
³⁴ University of California, Irvine, 101 The City Dr S Orange, CA, 92868, USA. Electronic address: jnahmias1@yahoo.com.
³⁵ Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO, 80045, USA. Electronic address: niti.Shahi@umassmemorial.org.
³⁶ Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO, 80045, USA. Electronic address: Steven.Moulton@childrenscolorado.org.
³⁷ University of Tennessee College of Medicine Chattanooga, 979 E 3rd Street Suite B 401, Chattanooga, TN, 37403, USA. Electronic address: robert.maxwell@universitysurgical.com.

PMID: 36509587
DOI: 10.1016/j.amjsurg.2022.12.006

Abstract

Background: Few studies have investigated risk factors for recurrence of blunt traumatic abdominal wall hernias (TAWH).

Methods: Twenty trauma centers identified repaired TAWH from January 2012 to December 2018. Logistic regression was used to investigate risk factors for recurrence.

Results: TAWH were repaired in 175 patients with 21 (12.0%) known recurrences. No difference was found in location, defect size, or median time to repair between the recurrence and non-recurrence groups. Mesh use was not protective of recurrence. Female sex, injury severity score (ISS), emergency laparotomy (EL), and bowel resection were associated with hernia recurrence. Bowel resection remained significant in a multivariable model.

Conclusion: Female sex, ISS, EL, and bowel resection were identified as risk factors for hernia recurrence. Mesh use and time to repair were not associated with recurrence. Surgeons should be mindful of these risk factors but could attempt acute repair in the setting of appropriate physiologic parameters.

Keywords: Abdominal trauma; Hernia; Trauma; Traumatic abdominal wall hernia.

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Conflict of interest statement

Declaration of competing interest The authors have no financial conflicts of interest to disclose.

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Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Affiliations

Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources