Veljkovic et al evaluated surgical patients for the risk of incisional hernia (IH) after a midline laparotomy. They identified patients who are at increased risk for this complication. The authors are from Clinical Center Vojvodina in Novi Sad, Serbia, Walter Reed Army Medical Center and the United States Military Cancer Institute.
Parameters:
(1) fascial suture length to incision length ratio (SIR)
(2) CDC grade of surgical site infection (SSI)
(3) number of days to suture removal or complete epithelialization
(4) body mass index (BMI)
(5) pain as a VAS scored from 0 to 40
(6) postoperative emesis scored from 0 to 40
|
Parameter |
Finding |
Points |
|
fascial suture to incision ratio |
< 4.2 |
1 |
|
|
>= 4.2 |
0 |
|
CDC grade of SSI |
none (0) |
0 |
|
|
superficial (1) |
0 |
|
|
deep (2) |
1 |
|
|
deep space or organ (3) |
1 |
|
suture removal or complete epithelialization |
<= 16 days |
0 |
|
|
> 16 days |
1 |
|
body mass index |
<= 24 kg per square m |
0 |
|
|
> 24 kg per square m |
1 |
|
pain VAS |
<= 20 |
0 |
|
|
> 20 |
1 |
|
postoperative emesis |
<= 3 |
0 |
|
|
> 3 |
1 |
score for incisional hernia risk =
= (32 * (points for suture to incision ratio)) + (30 * (points for SSI)) + (9 * (points for time to suture removal)) + (2 * (points for BMI))
|
Score |
Probability of IH |
Risk Group |
|
0 to 5 |
1% |
low risk |
|
6 to 15 |
10% |
moderate risk |
|
16 to 50 |
30% |
increased risk |
|
> 50 |
73% |
markedly increased risk |
Specialty: Gastroenterology
