2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias

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Authors: Arianna Birindelli ; Massimo Sartelli ; Salomone Di Saverio ; Federico Coccolini ; Luca Ansaloni ; Gabrielle H van Ramshorst ; Giampiero Campanelli ; Vladimir Khokha ; Ernest E Moore ; Andrew Peitzman ; George Velmahos ; Frederick Alan Moore ; Ari Leppaniemi ; Clay Cothren Burlew ; Walter L Biffl ; Kaoru Koike ; Yoram Kluger ; Gustavo P Fraga ; Carlos A Ordonez ; Matteo Novello ; Ferdinando Agresta ; Boris Sakakushev ; Igor Gerych ; Imtiaz Wani ; Michael D Kelly ; Carlos Augusto Gomes ; Mario Paulo Faro Jr ; Antonio Tarasconi ; Zaza Demetrashvili ; Jae Gil Lee ; Nereo Vettoretto ; Gianluca Guercioni ; Roberto Persiani ; Cristian Tranà ; Yunfeng Cui ; Kenneth Y Y Kok ; Wagih M Ghnnam ; Ashraf El-Sayed Abbas ; Norio Sato ; Sanjay Marwah ; Muthukumaran Rangarajan ; Offir Ben-Ishay ; Abdul Rashid K Adesunkanmi ; Helmut Alfredo Segovia Lohse ; Jakub Kenig ; Stefano Mandalà ; Raul Coimbra ; Aneel Bhangu ; Nigel Suggett ; Antonio Biondi ; Nazario Portolani ; Gianluca Baiocchi ; Andrew W Kirkpatrick ; Rodolfo Scibé ; Michael Sugrue ; Osvaldo Chiara ; Fausto Catena

MeSH: Abdominal Wall / surgery ; Disease Management ; Emergency Medical Services / methods* ; Emergency Medical Services / trends ; Guidelines as Topic* ; Hernia, Abdominal / surgery* ; Humans ; Polypropylenes / therapeutic use ; Surgical Mesh / trends ; Treatment Outcome

Keywords: Abdominal wall hernia ; Biologic mesh ; Bowel resection ; Contaminated wound ; Emergency surgery ; Hernia repair ; Incarcerated hernia ; Infected field ; Mesh repair ; Strangulated hernia

Abstract: Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.