An Australian Approach to Managing Traumatic Abdominal Wall Hernias

Abstract

Traumatic abdominal wall hernias (TAWH) occur in less than one percent of trauma presentations. In the absence of clinical guidelines, management is centre-specific and largely dependent on surgeon experience. This study describes the management of TAWH in a high volume Australian trauma centre. A single centre retrospective cohort study was performed. Adults with TAWH as a result of blunt trauma, between January 2016 and July 2020, were included. Primary outcomes were the mechanism of injury, presentation, timing of repair, and operative technique used. A total of 16 patients (63% male; median age 36 years; median Injury Severity Score [ISS] 19.5) were identified. In total, 75% were the result of a motor vehicle accident. A total of 13 patients (81%) underwent repair. Eight patients received repair during emergency exploration undertaken for concurrent injuries. Three patients had a delayed repair during index admission, and two patients had an elective repair. Primary tissue repair was performed in seven patients. Mesh repair was used in six. Patients were followed for a median of 55.5 days. One patient had a recurrence of hernia following primary repair. This local series demonstrates that traumatic abdominal wall hernias may be successfully repaired during index admission using tissue or mesh techniques.

Keywords

• acute surgical unit
• blunt trauma
• abdominal wall hernia
• traumatic abdominal wall hernia
• mesh
• hernia repair