Muscle herniae: Conservative and surgical management. Systematic review

Quaranta, Marco; Poeta, Nicola; Oliva, Francesco; Maffulli, Nicola

Abstract

Background
Muscle herniae are often unrecognized. The primary objective of this systematic review is to evaluate the outcomes of conservative and surgical management for muscle herniae. The secondary objective is to define the most appropriate management for muscle herniae depending on aetiology and size of the fascial defect.

Methods
The PRISMA guidelines were used to organize this systematic review to assess the different management modalities and identify possible criteria useful to guide the management of muscle herniae. An electronic search of PubMed and Scopus databases was performed.

Results
A total of 132 patients were identified. Conservative management was carried out in 22 (16.7%) patients, and 110 (83.3%) patients underwent surgical procedures. Pain was reported in 3/22 (13.6%) patients managed conservatively. Post-surgical pain was reported in 0/5 (0%) patients treated with autologous graft repair, 1/15 (6.7%) patient with mesh repair, 2/13 (15.4%) patients with direct repair and 11/77 (14.3%) patients with fasciotomy. Return to normal activity was possible in 16/22 (72.7%) patients treated conservatively, 5/5 (100%) patients undergoing autologous graft repair, 13/15 (86.7%) with mesh repair, 62/77 (80.52%) with fasciotomy and 4/12 (33.3%) with direct repair.

Conclusion
In congenital muscle herniae, fasciotomy should be considered the surgical choice to prevent complications. In post-traumatic muscle hernia, a small fascial defect can be treated with the direct suture repair, while mesh repair and autologous graft repair should be considered the most appropriate procedures to avoid severe complications such as compartment syndrome.

Citation

Quaranta, M., Poeta, N., Oliva, F., & Maffulli, N. (2023). Muscle herniae: Conservative and surgical management. Systematic review. Surgeon, 21(3), 181-189. https://doi.org/10.1016/j.surge.2022.02.003

• Journal Article Type: Article
• Acceptance Date: Feb 9, 2022
• Online Publication Date: Mar 12, 2022
• Publication Date: 2023-06
• Deposit Date: Jan 24, 2024
• Journal: The Surgeon
• Print ISSN: 1479-666X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 3
• Pages: 181-189
• DOI: https://doi.org/10.1016/j.surge.2022.02.003
• Keywords: Surgery
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1479666X22000294?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: Muscle herniae: Conservative and surgical management. Systematic review; Journal Title: The Surgeon; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.surge.2022.02.003; Content Type: article; Copyright: © 2022 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.