Mike:
Do not let this study overly concern you.
There are variables that people can personally control/modify to lessen the risk of an incisional hernia or parastomal hernia.
The likelihood of a hernia increases in anyone who has undergone an open abdominal surgical procedure. The long longitudinal surgical incision leaves a natural weakness along the linea aspera (the fine midline line that connects both sides of the abdominal connective tissue and musculature).
It is weakness in the abdominal wall + an increase in intra-abdominal pressure that creates the opportunity for a hernia to develop.
Excess abdominal weight (a round belly) is a primary contributor to development of a hernia. Excess weight/adipose tissue carried on the abdomen increases outward abdominal pressure, pushing on the intestines and organs. Keeping weight in check is immensely helpful.
Working on core strengthening is another approach to limit a hernia. Avoid holding your breath during any exertion/exercise. Holding one’s breath during an activity of effort increases infra-abdominal pressure that contributes to a hernia.
Wearing a mild compression belly tube/belly band (the same as originally designed to provide abdominal support to pregnant women as the fetus grows during pregnancy) is a wise preventative measure.
Wearing brief-style or boy short-style underware that has spandex or Lycra is also an option. Or long torso compressive camisoles or crew neck T-shirts. The compression provides a mild and constant inward pressure gradient to counteract the natural outward abdominal pressure gradient that exists due to abdominal adipose tissue, the effects of gravity when upright/standing, and the abdominal organs that exert an outward pressure on the weakened abdominal wall.
I am a fond consumer of undergarments made by a small British company called “ComFizz.” They offer a wide range of compression undergarments for those with an ostomy. Camisoles and t-shirts, belly bands, briefs, and specific hernia support bands. The undergarments are equally applicable/helpful for anyone after an ostomy reversal in minimizing likelihood of a hernia. They offer three levels of compression to meet different abdominal support needs.
www.comfizz.comComFizz has an informative web site. Orders are easy to place with a credit card. Orders arrive in about 2 weeks. Returns are easy to process. You can communicate with a fitting representative on-line or by telephone to guide you in placing an order and in selecting a garment. ComFizz has received several honors and awards by the NIH British Healthcare system.
People have unique skin and connective tissue compositions. People with fair complexions, as an example, often have skin/connective tissue that has less collagen and fibrin that will leave them at higher hernia risk.
I am 6 years post initial open abdominal surgery with 3 additional open procedures. Healing in all cases was by secondary intention (no sutures, no staples) due to accompanying infection. I am 100% hernia free. I am petitire with a low BMI and practice yoga (or Pilates) daily to keep my core strong. I wear ComFizz compressive garments (the women’s camisole is my GoTo day wear) and strongly recommend the quality and design of their undergarments - for both those with a current ostomy/stoma as well as after reversal.
We talk frequently about pro-active hernia management on the United Ostomy of America Assoc forum. Stop by any time.
http://www.uoaa.orgPro-active practices to minimize development of a hernia is far preferred to having to deal with a hernia. Hernia repair is notoriously prone to mesh failure and hernia recurrence. Hernias are not only asthetically troubling (looks like you are carrying a cantaloupe on your abdomen) but also can cause intestinal entrapment and small bowel obstructions.
That you are researching ways to limit your likihood of a hernia is commendable. There are variables that you can influence to lower your overall risk of a hernia.
But sometimes hernias “pop out” despite best intentions to the contrary. Connective tissue disorders or medications that lower skin/tissue integrity do contribute - often the need for the medication outweighs the hernia risk.
Al to say . . . if you develop a hernia do NOT beat yourself up about its unwelcomed presence. Hernias happen.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.
developed both. The reversal-site hernias were smaller both in width and length compared with the non-ileostomy-site hernias. Risk factors for the development of reversal-site incisional hernias were higher body mass index (BMI), lower age, open surgery, longer reversal time and a history of previous hernias. We did not detect a difference in the size of the incisional hernias that developed in patients with these specific risk factors. CONCLUSIONS Incisional hernias are a significant complication of ileostomy reversal. Further evaluation of the use of prophylactic mesh to reduce the incidence of incisional hernias may be worthwhile.