SynthesisThe journal of trauma and acute care surgery2025
Surgical management of incarcerated and strangulated inguinal hernias requiring urgent surgical intervention: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma.
Synthesis in The journal of trauma and acute care surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Comment to Evaluation of usefulness of manual reduction in themanagement of adult acute irreducible abdominal wall hernia.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Evaluation of usefulness of manual reduction in the management of adult acute irreducible abdominal wall hernia: a study from a community-based teaching hospital.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Early prediction of bowel necrosis in incarcerated groin hernia using parsimonious machine learning models: a retrospective cohort study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Laparoscopic Management of Small Bowel Obstruction and Ischemia Caused by Spontaneous Transomental Hernia in a Virgin Abdomen: A Case Report.Case reports in surgery · 2026Article
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Authors and funding
12 authors.
Funding
Abstract
backgroundPatients with acutely incarcerated or strangulated inguinal hernias require urgent surgical evaluation. Most literature on inguinal hernia management focuses on elective repairs. We aimed to provide evidence-based guidelines for managing inguinal hernias requiring urgent surgical intervention.
methodsAn evidence-based systematic review was performed. Clinically relevant questions regarding defined Population(s), Intervention(s), Comparison(s), and Outcome(s) were selected. These questions centered around the timing of intervention, the use of mesh, the surgical approach, and the use of antibiotics in patients who presented with incarcerated or strangulated inguinal hernias requiring urgent surgical interventions. A comprehensive literature search was completed from 1946 through March 11, 2024. The Grading of Recommendations Assessment, Development and Evaluation methodology was used in the creation of the recommendations. Consensus was achieved for all final recommendations.
resultsOf 7,038 articles reviewed, 34 met the inclusion criteria. Early intervention (<6 hours from symptom onset) was associated with a lower incidence of bowel resection (odds ratio [OR], 0.1 [0.05, 0.29]; p < 0.0001). Hernia repair with mesh was associated with decreased incidence of recurrence (OR, 0.34 [0.13, 0.87]; p = 0.02) and mixed results for surgical site infections. Laparoscopic repairs decreased recurrence rates (OR, 0.75 [0.58, 0.99]; p = 0.03) and had shorter hospital length of stay (mean difference, -3.00 [-5.54, -0.47]; p < 0.01) compared with open repairs. There were not enough studies to address the routine use of postoperative antibiotics. Quality was deemed very low with much of the literature being retrospective studies.
conclusionWe conditionally recommend early surgical intervention for adult patients presenting with acutely incarcerated or strangulated inguinal hernias who are deemed to require surgery. We conditionally recommend mesh repairs over primary tissue repairs and laparoscopic approaches over open approaches for this population. No recommendations can be made regarding the routine use of antibiotics. LEVEL OF EVIDENCE: Systematic Review/Meta-analysis; Level III.
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