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J R Soc Med. 1986 December; 79(12): 711–712.
PMCID: PMC1290569

Towards no incisional hernias: lateral paramedian versus midline incisions.


A prospective randomized controlled clinical trial is reported which compares midline with lateral paramedian incisions in relation to the development of incisional hernias at one year. Of 431 patients randomized, 329 were available for assessment one year later. Two patients suffered burst abdomen, both being in the lateral paramedian group. Twenty-two incisional hernias occurred, 2 in the lateral paramedian group and 20 in the midline group (P less than 0.001). Of the two types of incision, the lateral paramedian incision takes longer to perform, requires a longer incision, rarely results in dehiscence, and does confer protection against incisional hernia.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Pollock AV, Greenall MJ, Evans M. Single-layer mass closure of major laparotomies by continuous suturing. J R Soc Med. 1979 Dec;72(12):889–893. [PMC free article] [PubMed]
  • Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J (Clin Res Ed) 1982 Mar 27;284(6320):931–933. [PMC free article] [PubMed]
  • Donaldson DR, Hegarty JH, Brennan TG, Guillou PJ, Finan PJ, Hall TJ. The lateral paramedian incision--experience with 850 cases. Br J Surg. 1982 Oct;69(10):630–632. [PubMed]
  • Guillou PJ, Hall TJ, Donaldson DR, Broughton AC, Brennan TG. Vertical abdominal incisions--a choice? Br J Surg. 1980 Jun;67(6):395–399. [PubMed]
  • Ellis H, Gajraj H, George CD. Incisional hernias: when do they occur? Br J Surg. 1983 May;70(5):290–291. [PubMed]

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