{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:32:21Z","timestamp":1791329541197,"version":"4.3.1"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Eine geplante ventrale Hernie nach einer offenen Bauchbehandlung ist eine seltene Hernienentit\u00e4t, da aufgrund bereits etablierter Konzepte zur offenen Bauchbehandlung die Faszienverschlussrate gesteigert werden konnte. Nichtsdestotrotz gelingt ein Faszienverschluss nicht immer und eine geplante ventrale Hernie muss zu einem sp\u00e4teren Zeitpunkt operativ versorgt werden. Die Bauchdeckenrekonstruktion ist anspruchsvoll und bedarf der sorgf\u00e4ltigen pr\u00e4operativen Vorbereitung.<\/jats:p><jats:p>In einer monozentrischen retrospektiven Analyse wurden alle Narbenhernien von 2013 bis 2023 (n\u00a0=\u00a0632) identifiziert. Komplexe Narbenhernien im Sinne geplanter ventraler Hernien nach einem Laparostoma (n\u00a0=\u00a011) wurden selektiert. Die pr\u00e4operative Diagnostik und OP-Planung wurden den Patientenakten entnommen; OP-Techniken anhand der Operationsberichte analysiert. Die Literaturrecherche erfolgte auf PubMed (Medline).<\/jats:p><jats:p>Pr\u00e4operativ wurden in allen F\u00e4llen neben einer k\u00f6rperlichen Untersuchung eine Abdomensonografie, ein CT-Abdomen und eine Koloskopie durchgef\u00fchrt. Indikationen f\u00fcr ein Laparostoma waren vor allem Darmperforationen mit Peritonitis, ein abdominelles Kompartment, postoperative Fasziendehiszenzen (\u201ePlatzbauch\u201c) sowie Folge eines stumpfen oder penetrierenden Traumas. Die Gr\u00f6\u00dfe der Bauchwanddefekte betrug im Median horizontal 13\u00a0cm (6\u201335\u00a0cm) und vertikal 18\u00a0cm (10\u201328\u00a0cm). Seit 2018 wurde (6\/11) pr\u00e4operativ nach standardisiertem Schema Botulinumtoxin A injiziert. Bei allen Patienten gelang intraoperativ der mediane Faszienverschluss. Die Operationstechniken umfassten Sublay-, IPOM- und Sandwich-Repair sowie intraoperative Faszientraktion und Komponentenseparation.<\/jats:p><jats:p>Eine geplante ventrale Hernie nach einer offenen Bauchbehandlung ist eine komplexe Hernie, f\u00fcr die ein breites hernienchirurgisches Armamentarium ben\u00f6tigt wird. Die umfassende pr\u00e4operative Optimierung inkl. Botulinumtoxin-Infiltration sollte bei derart anspruchsvollen Hernien unbedingt erwogen werden, um die anatomiegerechte Rekonstruktion durch einen Mittellinienverschluss mit Netzaugmentation zu erreichen.<\/jats:p>","DOI":"10.1055\/a-2420-1303","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T23:53:50Z","timestamp":1732319630000},"page":"516-521","source":"Crossref","is-referenced-by-count":1,"title":["Geplante ventrale Hernie nach Abdomen apertum: Daten zur Versorgung einer komplexen Entit\u00e4t und Literatur\u00fcberblick"],"prefix":"10.1055","volume":"149","author":[{"given":"Angelina","family":"Klein","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus, Koblenz, 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Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1920-7090","authenticated-orcid":false,"given":"Sebastian","family":"Schaaf","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus, Koblenz, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s13017-018-0167-4","article-title":"The open abdomen in trauma and non-trauma patients: WSES guidelines","volume":"13","author":"F Coccolini","year":"2018","journal-title":"World J Emerg Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s00423-014-1240-4","article-title":"Management of the open abdomen using vacuum-assisted wound closure and mesh-mediated fascial traction","volume":"400","author":"A 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