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Invited Critique
January 2011January 17, 2011

Primum Non Nocere, or Leave That Ostomy AloneComment on “Incisional Hernias in Temporary Stoma Wounds”

Author Affiliations

Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Surg. 2011;146(1):99-100. doi:10.1001/archsurg.2010.282

The issue of incisional hernia has been present for as long as we have been performing abdominal operations. Schreinemacher et al present their data on the less-published hernias at stoma sites following closure and analyze the contributing risk factors. They noted a high rate of incisional hernia following stoma closure (32.4%) and found that a BMI of 30 or higher was the only contributing factor.

The study draws attention to a common condition about which the literature is sparse. The creation of an ostomy is a frequently undertaken surgical procedure, and reversal is undertaken in some patients. Studies1-4 on the fate of temporary stomas delve into the immediate postoperative outcomes following stoma closure. In contrast, Schreinemacher et al focus on the long-term complication of hernia occurrence at the stoma site after closure.