172 Chapter 7 [11]. Ethical approval was received by the local medical ethical commission (reference: W18_233#18.278). Data extraction Incisional hernia was defined as an abdominal wall defect at the site of surgery found either by physical examination or ultrasound. For hernia location the classification proposed by the European Hernia Society (EHS) was used [12]. Time from main surgery until hernia development was noted as well as duration of follow up, if reintervention for incisional hernia was performed, and recurrence. Anomaly type was defined as congenital or acquired [13]. The main operation was defined as the most extensive operation for the first disease that occurred in an infant. All procedures in which the abdominal cavity was entered were included. Inguinal operations were only included if the abdominal cavity was entered (e.g. intra-abdominal check for undescended testis via laparoscopy). Operative reports were searched for the description of the surgery performed, the operative approach (laparotomy or laparoscopy), age at main surgery, if the main surgery was an urgent procedure, American Society of Anesthesiologists (ASA) score during the main operation, if a wound infection occurred following the main surgery, if total parenteral feeding was received during the admission for the main surgery, if the patient had a history of prematurity or stoma formation/reversal and the total number of abdominal procedures the patient underwent. An operation was deemed urgent if the operation was executed within 72 hours following admission. Wound infection was noted only if described likewise in the patient file. History of stoma was dichotomized without making a distinction if the stoma was planned or part of urgent surgery. A child born before 37 weeks of gestational age (GA) was noted as preterm. Neonatal age at surgery was defined as an operation within the first 28 days of life. Total number of abdominal procedures were categorized (1, 2, 3, 4 or more) excluding redo surgery for IH. To evaluate if anomalies and risk factors were equally distributed over time during our study period, we divided the cohort into 4-year intervals based on the date of surgery. We divided incisional hernias into early (within 15 days after surgery) and late hernias. Moreover, data on the type of suture material used and type of laparotomy incision (transverse and midline) was subtracted for a second subgroup analysis. The suture resorption speed was divided into normal (Vicryl©, Novosyn©, Monocryl©) and slow (Polydiazone (PDS) and Monosyn plus©). In addition, sutures materials were categorized in monofilament and braided sutures. The mode of suturing was divided in continuous or intermittent.
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