Sangam: A Confluence of Knowledge Streams

Clinician preferences in the treatment of acutely symptomatic hernia: the 'MASH' survey

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dc.creator O'Connor, O. M.
dc.creator Burns, F. A.
dc.creator Proctor, V. K.
dc.creator Green, S. K.
dc.creator Sayers, A. E.
dc.creator Smart, N. J.
dc.creator Lee, M. J.
dc.date 2022-04-21T09:41:51Z
dc.date 2022-04-21T09:41:51Z
dc.date 2022-02-23
dc.date 2022-02-24
dc.date.accessioned 2023-02-17T19:47:26Z
dc.date.available 2023-02-17T19:47:26Z
dc.identifier Ann R Coll Surg Engl. 2022 Feb 23. doi: 10.1308/rcsann.2021.0304.
dc.identifier 35196151
dc.identifier 10.1308/rcsann.2021.0304
dc.identifier https://rde.dspace-express.com/handle/11287/622461
dc.identifier Annals of the Royal College of Surgeons of England
dc.identifier.uri http://localhost:8080/xmlui/handle/CUHPOERS/241966
dc.description INTRODUCTION: There is limited high-quality evidence to guide the management of acute hernia presentation. The aim of this study was to survey surgeons to assess current trends in assessment, treatment strategy and operative decisions in the management of acutely symptomatic hernia. METHODS: A survey was developed with reference to current guidelines, and reported according to Checklist for Reporting Results of Internet E-Surveys guidelines. Ethical approval was obtained from the University of Sheffield (UREC:034047). The survey explored practice in groin, umbilical/paraumbilical and incisional hernia presenting acutely. It captured respondent demographics, and preferences for investigations, treatment strategies and repair techniques for each hernia type, using a five-point Likert scale. RESULTS: Some 145 responses were received, of which 39 declared a specialist hernia practice. Essential investigations included urea and electrolytes (58.6%) and inflammatory markers (55.6%). Computed tomography scan of the abdomen was essential for assessment of incisional hernia (90.9%), but not for other hernia types. Bowel compromise drives early surgery, and increasing American Society of Anesthesiology score pushes towards non-operative management. Type of repair was driven by hernia contents, with increasing contamination associated with increased rates of suture repair. Where mesh was proposed in contaminated settings, biological types were preferred. There was variation in the potential use of laparoscopy for groin hernia. CONCLUSIONS: This survey provides a snapshot of current trends in the management of acutely symptomatic hernia. It demonstrates variation across aspects of assessment and repair technique. Additional data are required to inform practice in these areas.
dc.description The article is available via Open Access. Click on the 'Additional link' above to access the full-text.
dc.description Not permitted
dc.language eng
dc.publisher Royal College of Surgeons
dc.relation https://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2021.0304?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
dc.rights © 2022 The Royal College of Surgeons of England
dc.rights http://creativecommons.org/publicdomain/zero/1.0/
dc.subject Hernia
dc.subject Survey
dc.title Clinician preferences in the treatment of acutely symptomatic hernia: the 'MASH' survey
dc.type Journal Article
dc.type aheadofprint


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