Challenges in prevention, diagnosis and treatment of abdominal wall hernias

An abdominal wall fracture is a weak spot where the intestines bulge outwards. This can be painful, cause cosmetic complaints or potentially life-threatening clamping. Abdominal wall fractures can be congenital or acquired. In this thesis, techniques for the prevention, diagnosis and treatment of abdominal wall fractures are researched. Acquired abdominal wall fractures after surgery include scar or stoma rupture. Surgical technique and materials used when closing the abdominal wall after abdominal surgery affect the occurrence of a scar rupture. Therefore, for this study, a survey was conducted among Dutch surgeons to identify what technique they use. It also investigated the occurrence of scar ruptures when two different types of suture material (insoluble versus slowly absorbable) were used to close the abdominal wall after surgery. In addition, it was investigated whether there are differences in detecting a scar rupture when using either ultrasound or physical examination. The effectiveness and comfort of an innovative stoma band were investigated. A final focus of research in the thesis were two congenital types of abdominal wall fractures about which little is known yet; the so-called lumbar fracture and linea arcuata hernia.