Hernia : the journal of hernias and abdominal wall surgery
-
Randomized Controlled Trial Comparative Study
Strategies of smoking cessation intervention before hernia surgery--effect on perioperative smoking behavior.
Although it is now generally accepted that patients should be advised to quit smoking before surgery, the effect of low-intensive smoking cessation intervention, both on preoperative smoking behavior and on risk reduction, remains unclear. Our objective was to study the effect on perioperative smoking behavior and on postoperative wound infection of different types of low-intensive intervention before herniotomy. ⋯ Low-intensive smoking cessation intervention helps approximately one fifth of patients to stop smoking perioperatively. Patients who are reminded in addition to preoperative advice are more likely to stop or reduce smoking. Failure to stop smoking is greater if the patients are not motivated and if the CO breath test is high at the time of the preoperative advice.
-
Randomized Controlled Trial
A pragmatic approach to cutaneous nerve division during open inguinal hernia repair.
Chronic pain following inguinal hernia repair may be related to the handling of cutaneous nerves. This study aims to investigate the frequency of cutaneous nerve division in routine practice and the effect that nerve division has on long-term pain outcomes. ⋯ The division of cutaneous nerves during inguinal hernia repair has no significant effect on postoperative pain. However, there are very few adverse outcomes, and so, a pragmatic approach of dividing nerves when they would otherwise be damaged may be appropriate.
-
Randomized Controlled Trial Comparative Study
The comparison of laparoscopic and open ventral hernia repairs: a prospective randomized study.
The laparoscopic approach has emerged in the search for a surgical technique to decrease the morbidity associated with conventional repair of ventral hernias. In this study we aimed to compare the results of our open and laparoscopic ventral hernia repairs prospectively. ⋯ The laparoscopic approach appears to be as effective as open repairs in the treatment of ventral hernias. Advanced surgical skill, laparoscopic experience and high technology are mandatory factors for successful ventral hernia repair.
-
Randomized Controlled Trial
Cooling for the reduction of postoperative pain: prospective randomized study.
Hernia surgery has been associated with severe pain within the first 24 h postoperatively. The application of cold or cryotherapy has been in use since at least the time of Hippocrates. The physiological and biological effects from the reduction of temperature in various tissues include local analgesia, inhibited oedema formation and reduced blood circulation. ⋯ Pain levels then gradually decreased for both the trial groups during the first 24 h postoperatively. There were significant differences in the VAS scores between the groups at 2, 6 and 24 h. We conclude that local cooling is a safe and effective technique for providing analgesia following inguinal hernia repair.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Primary closure of laparotomies with high risk of incisional hernia using prosthetic material: analysis of usefulness.
Incisional hernia continues to be a serious postoperative complication in abdominal surgery. We present a prospective randomised study to evaluate the usefulness of placement of a supra-aponeurotic polypropylene mesh in the primary closure of laparotomies with a high risk of incisional hernia. ⋯ No incisional hernia was detected in the group in which closure was made using the mesh (P=0.02). Use of prosthetic material (polypropylene mesh) in the primary closure of laparotomies with a high risk of incisional hernia is useful for reduction of the rate of incisional hernias.