The effect of increasing body mass index on wound complications in open ventral hernia repair with mesh

2019 ◽  
Vol 218 (3) ◽  
pp. 560-566 ◽  
Author(s):  
Luciano Tastaldi ◽  
David M. Krpata ◽  
Ajita S. Prabhu ◽  
Clayton C. Petro ◽  
Steven Rosenblatt ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Wound Complications ◽  
Open Ventral Hernia Repair

Impact of body mass index on open ventral hernia repair: A retrospective review

Surgery ◽  
2017 ◽  
Vol 162 (6) ◽  
pp. 1320-1329 ◽  
Author(s):  
Lily Owei ◽  
Robert A. Swendiman ◽  
Rachel R. Kelz ◽  
Daniel T. Dempsey ◽  
Kristoffel R. Dumon
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Retrospective Review ◽  
Ventral Hernia Repair ◽  
Open Ventral Hernia Repair

National Outcomes for Open Ventral Hernia Repair Techniques in Complex Abdominal Wall Reconstruction

2015 ◽  
Vol 81 (8) ◽  
pp. 778-785 ◽  
Author(s):  
Samuel W. Ross ◽  
Bindhu Oommen ◽  
Ciara Huntington ◽  
Amanda L. Walters ◽  
Amy E. Lincourt ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Multivariate Regression ◽  
Ventral Hernia Repair ◽  
Abdominal Wall Reconstruction ◽  
Wound Complications ◽  
Improvement Program ◽  
Major Complications ◽  
Open Ventral Hernia Repair

Modern adjuncts to complex, open ventral hernia repair often include component separation (CS) and/or panniculectomy (PAN). This study examines nationwide data to determine how these techniques impact postoperative complications. The National Surgical Quality Improvement Program database was queried from 2005 to 2013 for inpatient, elective open ventral hernia repairs (OVHR). Cases were grouped by the need for and type of concomitant advancement flaps: OVHR alone (OVHRA), OVHR with CS, OVHR with panniculectomy (PAN), or both CS and PAN (BOTH). Multivariate regression to control for confounding factors was conducted. There were 58,845 OVHR: 51,494 OVHRA, 5,357 CS, 1,617 PAN, and 377 BOTH. Wound complications (OVHRA 8.2%, CS 12.8%, PAN 14.4%, BOTH 17.5%), general complications (15.2%, 24.9%, 25.2%, 31.6%), and major complications (6.9%, 11.4%, 7.2%, 13.5%) were different between groups ( P < 0.0001). There was no difference in mortality. Multivariate regression showed CS had higher odds of wound [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.5–2.0], general (OR 1.5, 95% CI: 1.3–1.8), and major complications (OR 2.1, 95%, CI: 1.8–2.4), and longer length of stay by 2.3 days. PAN had higher odds of wound (OR 1.5, 95%, CI: 1.3–1.8) and general complications (OR 1.7, 95% CI: 1.5–2.0). Both CS and PAN had higher odds of wound (OR 2.2,95%, CI: 1.5–3.2), general (OR 2.5, 95%, CI: 1.8–3.4), and major complications (OR 2.2, 95%CI: 1.4–3.4), and two days longer length of stay. In conclusion, patients undergoing OVHR that require CS or PAN have a higher independent risk of complications, which increases when the procedures are combined.

Impact of body mass index on minimally invasive ventral hernia repair: an ACS-NSQIP analysis

Hernia ◽  
2019 ◽  
Vol 23 (5) ◽  
pp. 899-907 ◽  
Author(s):  
L. Owei ◽  
R. A. Swendiman ◽  
S. Torres-Landa ◽  
D. T. Dempsey ◽  
K. R. Dumon
Keyword(s):  
Body Mass Index ◽  
Minimally Invasive ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Acs Nsqip

Intra-Abdominal Placement of Antimicrobial-Impregnated Mesh is Associated with Noninfectious Fever

2006 ◽  
Vol 72 (12) ◽  
pp. 1205-1209 ◽  
Author(s):  
William S. Cobb ◽  
B. Lauren Paton ◽  
Yuri W. Novitsky ◽  
Michael J. Rosen ◽  
Kent W. Kercher ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
In Vivo Models ◽  
Postoperative Fever ◽  
Dual Mesh

The antimicrobial, silver/chlorhexidine, when impregnated on mesh has been demonstrated to resist mesh infection in in vitro and in vivo models. The clinical, human systemic response to intraperitoneal placement of silver/chlorhexidine-impregnated mesh has not been investigated to date. Between October 2002 and November 2004, all in-patients undergoing laparoscopic ventral hernia repair were retrospectively analyzed. All repairs used expanded polytetraflouroethylene (ePTFE) Dual Mesh (DM) or ePTFE impregnated with silver/chlorhexidine, Dual Mesh Plus (DM+). Patient demographics, hernia characteristics, mesh type, operative details, and hospital course data were collected. Noninfectious fevers were defined as a temperature greater than 100.4 F without an identified source. Standard statistical methods were used. During the 2-year study period, 120 patients underwent laparoscopic ventral hernia repair (DM = 55, DM+ = 65). The two groups were similarly matched in terms of age, body mass index, American Society of Anesthesiologists score, defect size, and mesh size. Postoperative fever without an identified source occurred in 10 (18.2%) patients with DM and in 25 (38.5%) patients using DM+ (P = 0.015). A multivariant analysis revealed that only mesh type and body mass index predicted postoperative fever. All fevers resolved within the first 72 hours in the DM patients; however, 16 per cent of the DM+ group had persistent fevers of unknown origin after 72 hours. Within the DM+ group, patients with postoperative fevers had significantly longer postoperative stays (4.8 days vs 3.0 days; P = 0.009). The use of antimicrobial-impregnated ePTFE mesh with silver/chlorhexidine in laparoscopic ventral hernia repair is associated with noninfectious postoperative fever. In our patients, the evaluation and management of these fevers resulted in a significantly longer hospital stay.

Outcomes of Laparoscopic versus Open Fascial Component Separation for Complex Ventral Hernia Repair

2015 ◽  
Vol 81 (7) ◽  
pp. 714-719 ◽  
Author(s):  
Nathaniel Ng ◽  
Mallory Wampler ◽  
Humberto Palladino ◽  
Francisco Agullo ◽  
Brian R. Davis
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Hernia Recurrence ◽  
Component Separation ◽  
Physical Exam ◽  
Recurrence Rates

Ventral hernia recurrence rates have improved with advancements in technique. Open and laparoscopic fascial component separation techniques improve recurrence rates by allowing a tension free closure. This study examines laparoscopic component separation (LCS) and open component separation (OCS) techniques in the repair of complex ventral hernias and compares factors affecting patient outcomes. A retrospective chart review of patients who underwent ventral hernia repair with LCS and OCS was conducted between 2009 and 2013. Patient characteristics and outcomes were documented. Hernia recurrence was determined using physical exam and computed tomography if physical exam was equivocal. Univariate and multivariate analyses were performed. Ten patients underwent LCS and 38 underwent OCS. The rate of wound infection in the LCS group was 20 per cent versus 50 per cent in the OCS group. The overall rate of recurrence after LCS was 20 per cent, and 26 per cent in the OCS group. For body mass index > 30, the recurrence rate was 20 per cent in the LCS group and 29 per cent ( P = 0.5) in the open group. The use of LCS demonstrates a trend in the reduction of hernia recurrence and wound infection overall and in patients with body mass index > 30 compared with OCS.

scholarly journals Role of Tranexamic Acid for Seroma Prevention in Obese Patients Undergoing Laparoscopic Ventral Hernia Repair Under Spinal Anesthesia

2021 ◽  
Vol 15 (10) ◽  
pp. 3488-3490
Author(s):  
Rizwan Khan ◽  
Mahabub Aalam ◽  
Naeem Ahmed ◽  
Muddasar Pervaiz ◽  
Zahid Saeed
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Tranexamic Acid ◽  
Spinal Anesthesia ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Seroma Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Obese Patients

Objective: The aim of this study is to determine the effectiveness of tranexamic acid for seroma prevention in obese patients undergoing laparoscopic ventral hernia repair under spinal anesthesia. Study Design: Cross sectional study Place and Duration: Jinnah Postgraduate Medical Center (JPMC) Karachi, 1st July 2020 to 30th June 2021. Methods: There were one hundred and ten patients f both genders had abdominal hernia were included in this study. We have taken written consent from all the patients for detailed demographics age, sex and body mass index. Patients were undergone for laparoscopic ventral hernia repair under spinal anesthesia in OPD. The size and contents of the defect were determined by an abdominal and pelvic ultrasound. All patients received postoperative tranexamic acid. Drains were put in to measure the amount of seroma that was produced as a result of the procedure. SPSS 22.0 was used to analyze all of the data. Results: 42.23±6.55 years were the mean age of the patients. Mean Body mass index was 32.13±3.43 kg/m2. Majority of the patients 74 (67.3%) were females and rest of the patients 36 (32.7%) were males. In 91 (82.7%) cases seroma reduction was calculated within week. Only 41 of the 110 patients had drain output of less than 150 ml, 55 had drain output of 150-300 ml, and 14 had drain output greater than 300 ml. Seroma formation was found among 7 (6.4%) cases. Conclusion: Tranexamic acid was found to be efficient in minimizing postoperative seroma formation in ventral hernia repairs, according to the findings of this study. Keywords: Laparoscopic, Tranexamic acid, Plasminogen, Seroma, Obese Patients

The cost of preventable comorbidities on wound complications in open ventral hernia repair

2016 ◽  
Vol 206 (1) ◽  
pp. 214-222 ◽  
Author(s):  
Tiffany C. Cox ◽  
Laurel J. Blair ◽  
Ciara R. Huntington ◽  
Paul D. Colavita ◽  
Tanushree Prasad ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Wound Complications ◽  
Open Ventral Hernia Repair ◽  
The Cost
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