Predictive factors for complexity in abdominal wall hernias: a literature scope review

Abstract

ABSTRACT Introduction: Abdominal wall hernias encompass both ventral and incisional hernias, often poorly classified regarding complexity in general. This study aims to conduct a review on the primary topics related to defining the complexity of ventral hernias. Methods: this is a scope review conducted following the guidelines recommended by the PRISMA-ScR directive. Searches were carried out in electronic databases including PubMed, LILACS, and EMBASE, using the descriptors: Abdominal Hernia, Hernia, Ventral Hernia, Incisional Hernia, Complex, Classification, Classify, Grade, Scale, and Definition. Combinations of these terms were employed when appropriate. Inclusion criteria encompassed articles with definitions and classifications of complex hernias, as well as those utilizing these classifications to guide treatments and patient allocation. Synonyms and related topics were also considered. Articles outside the scope or lacking the themes in their title or abstract were excluded. The database search was conducted up to July 29, 2023. Results: several hernia classifications were identified as useful in predicting complexity. For this study, we considered six main criteria: size and location, loss of domain, use of abdominal wall relaxation techniques, characteristics of imaging exams, status of the subcutaneous cellular tissue, and likelihood of recurrence. Conclusion: complex abdominal wall hernias can be defined by characteristics analyzed collectively, relating to the patients previous clinical status, size and location of the hernia defect, status of subcutaneous cellular tissue, myofascial release techniques, and other complicating factors.

Keywords

• Abdominal Hernia
• Hernia
• Classification
• Incisional Hernia