Selected conditions associated with an increased incidence of incisional hernia: A review of molecular biology |
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| Authors: | Matthew J Reilly Nicholas K Larsen Swati Agrawal Finosh G Thankam Devendra K Agrawal Robert J Fitzgibbons |
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| Institution: | 1. Creighton University School of Medicine, Omaha, NE, 68178, USA;2. Department of Surgery, Creighton University Medical Center, Omaha, NE, 68131, USA;3. Department of Translational Research, Western University of Health Sciences, Pomona, CA, 91766, USA;1. Division of Surgical Oncology, Department of Surgery, Ohio State University Comprehensive Cancer Center and Ohio State University Wexner Medical Center, Columbus, OH, USA;2. School of Medicine and Public Health, University of Wisconsin-Madison, USA;3. Division of Surgical Oncology, Indiana University School of Medicine, Indianapolis, IN, USA;4. Moi Teaching and Referral Hospital, Eldoret, Kenya;5. Division of Endocrine Surgery, University of Wisconsin-Madison, USA;1. Department of Surgery, University of Michigan, Ann Arbor, MI, USA;2. Center for Global Surgery, University of Michigan, Ann Arbor, MI, USA;1. University of Utah, School of Medicine, United States;2. University of Utah, Department of Surgery, Division of Urology, United States;3. Houston Methodist Hospital, Department of Surgery, United States;4. University of Illinois at Chicago, College of Medicine, United States;5. University of Utah, Department of Internal Medicine, Division of Epidemiology, United States;6. University of Utah, Department of Surgery, Division of Vascular Surgery, United States;1. Sainte Anne Military Teaching Hospital, Department of Oncologic and Digestive Surgery, Toulon, France;2. French Military Health Service Academy, Ecole du Val-de-Grâce, Paris, France |
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| Abstract: | BackgroundIncisional hernias (IH) following a laparotomy, on average, occur in 10–20% of patients, however, little is known about its molecular basis. Thus, a better understanding of the molecular mechanisms could lead to the identification of key target(s) to intervene pre-and post-operatively.MethodsWe examined the current literature describing the molecular mechanisms of IH and overlap these factors with smoking, abdominal aortic aneurysm, obesity, diabetes mellitus, and diverticulitis.ResultsThe expression levels of collagen I and III, matrix metalloproteinases, and tissue inhibitors of metalloproteases are abnormal in the extracellular matrix (ECM) of IH patients and ECM disorganization has an overlap with these comorbid conditions.ConclusionUnderstanding the pathophysiology of IH development and associated risk factors will allow physicians to identify patients that may be at increased risk for IH and to possibly act preemptively to decrease the incidence of IH. |
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| Keywords: | Incisional hernia Abnormal wound healing ECM disorganization Comorbidities Matrix metalloproteinases |
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