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The Instable Scar

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Recurrent Hernia

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Abstract

There is increasing evidence that inguinal hernia formation is based on a disorder of the connective tissue biology [1]–[12]. Similarly, secondary herniations as incisional hernias or diverse recurrent hernias are supposed to be associated with biological factors that provoke an instable scar formation during the wound-healing process. Patients with congenital connective tissue disorders have a higher risk of developing of incisional or recurrent hernias [13,14]. Furthermore, aneurismal disease, as another collagen disorder, has repeatedly been shown to be associated with an increased risk for the development of incisional hernias [15]–[17]. Previous work was able to support the hypothesis of a dysregulation of the collagen metabolism in patients with incisional hernias. In patients with either primary or recurrent incisional hernias, a significantly decreased ratio of collagen type I to type III and alterations of collagen-interacting proteins were found [18]–[21]. An alteration of the collagen composition was further verified by a comparative immunhistochemical analysis of surgical mesh explants where patients operated for hernia recurrence had a lowered collagen I/III ratio as compared to patients operated due to mesh infection or mesh-related pain [22].

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Authors and Affiliations

  1. Chirurgische Klinik, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    R. Rosch, K. Junge, P. Lynen-Jansen, P. R. Mertens & V. Schumpelick

Authors
  1. R. Rosch
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  2. M. Binnebösel
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  3. K. Junge
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  4. P. Lynen-Jansen
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  5. P. R. Mertens
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  6. U. Klinge
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  7. V. Schumpelick
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Editor information

Editors and Affiliations

  1. Chirurgische Klinik, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    Volker Schumpelick

  2. Department of Surgery, Creighton University, 601 North 30th Street Suite 3740, Omaha, NE, 68131, USA

    Robert J. Fitzgibbons

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© 2007 Springer-Verlag Berlin Heidelberg

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Rosch, R. et al. (2007). The Instable Scar. In: Schumpelick, V., Fitzgibbons, R.J. (eds) Recurrent Hernia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68988-1_6

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  • DOI: https://doi.org/10.1007/978-3-540-68988-1_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-37545-6

  • Online ISBN: 978-3-540-68988-1

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