Prevention of Postoperative Ventral Hernias

Study Overview
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Brief Summary
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The research is aimed at identifying factors of herniation after median laparotomy and developing surgical methods for preventing postoperative ventral hernias and eventrations.

Detailed Description
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At the first stage, an analysis of the prevalence of postoperative ventral hernias in patients after median laparotomies in urgent surgery will be performed, with the identification of factors contributing to the development of postoperative ventral hernias. At the next stage, the investigators will search for the most reliable methods of suturing the white line of the abdomen, taking into account the risk of hernia formation, with their implementation in patients operated in an emergency through median laparotomic access in comparison with traditionally used methods. In conclusion, an algorithm will be developed for selecting the method of surgical prevention of postoperative ventral hernias, taking into account the risk of their development.

Official Title
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Prevention of Postoperative Ventral Hernias After Median Laparotomy in Urgent Surgery

Conditions
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Gangrenous Postoperative Ventral Hernia (Diagnosis), Dehiscence of Laparotomy Wound

Intervention / Treatment
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* Procedure: Suturing of a laparotomic wound with modified methods


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients of both sexes aged 18 years and older who are expected to perform median laparotomy on a planned or emergency basis. Patients who have signed an informed consent to participate in the study, after the purpose and meaning of the study have been explained to them. Patients who follow the doctor's instructions. Exclusion Criteria: The death of the patient. Stage IV cancer Hernia repair with hernioplasty, including simultaneous surgery Refusal of the patient to cooperate with the researcher.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Low risk of herniation.<br>Use of any method of suturing, including modified. | Procedure: Suturing of a laparotomic wound with modified methods<br>* Suturing the white line of the abdomen with the help of developed techniques aimed at preventing hernias and eventrations<br>|
| The average risk of hernia formation<br>The application of modified methods of closure of laparotomy wound. | Procedure: Suturing of a laparotomic wound with modified methods<br>* Suturing the white line of the abdomen with the help of developed techniques aimed at preventing hernias and eventrations<br>|
| high risk of herniation<br>The use of alloplastic methods of closure of laparotomy wound. | Procedure: Suturing of a laparotomic wound with modified methods<br>* Suturing the white line of the abdomen with the help of developed techniques aimed at preventing hernias and eventrations<br>|
| The presence of eventrations<br>The use of alloplastic methods of suturing a laparotomic wound in the absence of suppuration. | Procedure: Suturing of a laparotomic wound with modified methods<br>* Suturing the white line of the abdomen with the help of developed techniques aimed at preventing hernias and eventrations<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wound complications | Frequency of wound complications in the early postoperative period. | 2 weeks | 
| Eventration | Frequency of events in the early postoperative period | 2 weeks | 
| Pain syndrome | The severity of pain syndrome in the postoperative scar after midline laparotomy using a verbal scale of pain syndrome | 2 year | 
| Postoperative ventral hernia | Frequency of postoperative ventral hernia in the late postoperative period | 2 year | 
| Defects in the aponeurosis | Frequency of aponeurosis defects in the late postoperative period | 2 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative ventral hernia, eventrat, defects of the fascia, laparotomic wound suture, preventive prosthetics of a laparotomic wound