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Invited Critique
August 2010

Mom Is Not Permitted to Be IllComment on “Impact of Race and Socioeconomic Status on Presentation and Management of Ventral Hernias”

Author Affiliations

Author Affiliations: Surgical Service, Edward Hines Jr VA Hospital, Hines, and Loyola University Medical Center, Maywood, Illinois.

Arch Surg. 2010;145(8):780. doi:10.1001/archsurg.2010.142

In their article “Impact of Race and Socioeconomic Status on Presentation and Management of Ventral Hernias,” Bowman et al describe a disparity by race and socioeconomic status in patients' presentation with ventral hernias. They studied 321 consecutive patients who had ventral hernia repair from 2005 to 2008; women (62%) outnumbered men (38%) and black individuals were significantly younger (mean age, 48 years) than white individuals (mean age, 56 years). Patients' socioeconomic status was estimated by type of insurance and from US Census Bureau median household income by zip code. All patients had insurance coverage: 81% private, 19% public. While 92 patients were reported to have a “complicated hernia presentation,” implied as an incarcerated hernia, physical characteristics of incarcerated hernia were unspecified. Both laparoscopic and open approaches to hernia repair were used uniformly across racial and socioeconomic groups. Remarkably, primary repair was performed in 17% of patients. Thus, more recurrent hernias after primary repair are likely with time.1

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