Abstract
Introduction
Achieving adequate surgical exposure is fundamental to good surgical practice. Traditionally, in the repair of ventral and open inguinal hernias, this has been accomplished with the aid of self-retaining retractors or by extending the incision length. We propose that using disposable wound protectors, surgical exposure will be improved for a given incision length in the repair of ventral and open inguinal hernias, compared to traditional methods.
Method
Through the use of an animal tissue model, we compared incisions of varying lengths and measured the dimensions of the exposure achieved with disposable wound protectors (Alexis™) and a Mollison self-retainer. We calculated the surface area and, therefore, exposure gained using the specified wound retraction devices and compared the results.
Results
The average superficial surface area of wound with a self-retainer compared to the small and extra-small disposable wound protector was 2.65 cm2 vs 2.27 cm2 (small) and 2.2 cm2 (extra-small) for 2 cm incision length, 3.6 cm2 vs 4.93 cm2 and 4.2 cm2 for 3 cm incision length, 5.19 cm2 vs 8.25 cm2 and 6.27 cm2 for 4 cm incision length, 6.17 cm2 vs 12.25 cm2 and 9.07 cm2 for 5 cm incision length, and 8.75 cm2 vs 16.73 cm2 and 10.78 cm2 for 6 cm incision length [p = 0.038 (small) and p = 0.049 (extra-small)]. Our results show a statistically significant increase in surface area of a wound for each incision length when a disposable wound protector was used for exposure, compared to a self-retainer.
Conclusion
Our results demonstrate that the use of disposable wound protectors provides superior surgical exposure for a given incision length compared to traditional techniques in the repair of ventral and open inguinal hernia repairs.
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Lawson, J., McGill, A., Meares, H. et al. Wound protectors for improved exposure in open hernia repair. Hernia 23, 1215–1219 (2019). https://doi.org/10.1007/s10029-019-01952-6
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DOI: https://doi.org/10.1007/s10029-019-01952-6