Current Surgical Management of the Acutely Incarcerated Ventral Hernia

AbstractPurpose of ReviewAcutely incarcerated ventral hernias represent a complex disease process in an increasing complex population. Acute incarceration can lead to strangulation and worsen morbidity and mortality. Identifying best practices based upon available evidence is paramount to optimize patient outcomes. The following is a review of the most recent literature in the management of acutely incarcerated ventral hernias.Recent FindingsEvidence suggests early intervention (<  24 h) following incarceration mitigates the risk of strangulation and improves outcomes. The presence of ascites, an acute hernia angle, and bowel wall attenuation on computed tomography may help identify at risk patients. Fascial reinforcement with mesh is supported in hernias >  3 cm, but evidence supporting synthetic or biologic mesh use is conflicting in clean-contaminated and contaminated cases.SummaryAcutely incarcerated ventral hernias represent a complex disease process for which high-level evidence supporting best practices is sparse, and individualized surgical care can have significant impact on patient outcomes.

Source: Current Surgery Reports - August 3, 2020 Category: Surgery Source Type: research