LACING TECHNIQUE USING DERMAL AUTOGRAFTS FOR THE MANAGEMENT OF LARGE INCISIONAL HERNIAS

Between 1980 and 1990, 25 patients were treated for large incisional h ernias using the skin lacing technique. Twenty-four hernias were midli ne and one was at the site of a McBurney incision. Hernia defects were greater than 10 cm in diameter for 24 patients. A 1 cm-wide uninterru pted segment of skin was harvested from excess skin overlying the hern ia and was then alternatively passed through the left and right fascia l margins of the hernia. The operative mortality was nil. Two wound ab scesses were drained locally and did not mandate removal of the skin l ace. After a mean follow-up of 4.9 years, 3 recurrences were observed. Among 22 patients who had a successful repair of their incisional her nia, 20 returned to their previous occupations and two others reported improvement in performing their daily tasks. The skin lacing techniqu e is an interesting alternative to other more sophisticated techniques in the management of large incisional hernias.