Is there any superiority of the different abdominal closure techniques for primary closure in high-risk patients?

Introduction
Incisional hernia continues to be one of the major problems of surgery due to its high incidence rate and high morbidity. The aims of this study are to compare different repair techniques with primary repair techniques for the risk of incisional hernia.

Material and methods
High-risk patients who had a midline incision of the abdomen were included in this study. Patients were divided into four groups. Each group contained 20 patients. Patients of group 1 were operated on using primary repair. In group 2 Cardiff repair technique was used. The patients in group 3 were repaired with Keel technique. The patients of group 4 were repaired with onlay technique. Patients were followed up with physical examination at 3-month periods in the first year after surgery and 6-month periods in the following two years. Incisional hernia, occurrence time and other complications were noted.

Results
Eighty patients who had high risk of incisional hernia were included in this study. 47.5% of them were female and 52.5% of them were male. The average age of patients was 59.2 ±12.95. Average hospitalization time was 8.5 days (4–28 days). Average follow-up was 18 months (6–34 months). In total 4 (5%) patients had recurrence. Fifteen percent of patients in group 1 had recurrence and 5% of patients in group 2 had recurrence. There was no recurrence in other groups. There was no significant difference for incisional hernia and the other complications between groups (p = 0.368).

Conclusions
There was no significant difference between the techniques in terms of the development of incisional hernias or complications.