Impact of Modifiable Comorbidities on Wound Complications after Ventral Hernia Repair

2018 ◽  
Vol 227 (4) ◽  
pp. e136
Author(s):  
Hemasat Alkhatib ◽  
Luciano Tastaldi ◽  
Clayton C. Petro ◽  
Dominykas Burneikis ◽  
David Krpata ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Wound Complications

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.

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

Comparative study of wound complications: Isolated panniculectomy versus panniculectomy combined with ventral hernia repair

2012 ◽  
Vol 177 (2) ◽  
pp. 387-391 ◽  
Author(s):  
Alla Y. Zemlyak ◽  
Paul D. Colavita ◽  
Sofiane El Djouzi ◽  
Amanda L. Walters ◽  
Logan Hammond ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Comparative Study ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Wound Complications

Patterns of Recurrence and Mechanisms of Failure after Open Ventral Hernia Repair with Mesh

2017 ◽  
Vol 83 (11) ◽  
pp. 1275-1282 ◽  
Author(s):  
Jeremy A. Warren ◽  
Sean P. McGrath ◽  
Allyson L. Hale ◽  
Joseph A. Ewing ◽  
Alfredo M. Carbonell ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Mesh Fixation ◽  
Wound Complications ◽  
Light Weight ◽  
Group 2 ◽  
Clean Contaminated ◽  
Recurrence Group ◽  
Group 1

Recurrence after ventral hernia repair (VHR) remains a significant complication. We sought to identify the technical aspects of VHR associated with recurrence. Patients who underwent open midline VHR between 2006 and 2013 (n = 261) were retrospectively evaluated. Patients with recurrence (Group 1, n = 48) were compared with those without recurrence (Group 2, n = 213). Smoking, diabetes, and body mass index were not different between groups. More patients in Group 1 underwent clean-contaminated, contaminated, or dirty procedures (43.8 vs 27.7%; P = 0.021). Group 1 had a higher incidence of surgical site occurrence (52.1 vs 32.9%; P = 0.020) and surgical site infection (43.8 vs 15.5%; P < 0.001). Recurrences were due to central mesh failure (CMF) (39.6%), midline recurrence after biologic or bioabsorbable mesh repair (18.8%), superior midline (16.7%), lateral (16.7%), and after mesh explantation (12.5%). Most CMF (78.9%) occurred with light-weight polypropylene (LWPP). Recurrence was higher if the midline fascia was unable to be closed. Recurrence with midweight polypropylene (MWPP) was lower than biologic (P < 0.001), bioabsorbable (P = 0.006), and light-weight polypropylene (P = 0.046) mesh. Fixation, component separation technique, and mesh position were not different between groups. Wound complications are associated with subsequent recurrence, whereas midweight polypropylene is associated with a lower overall risk of recurrence and, specifically, CMF.

Primary Fascial Closure During Laparoscopic Ventral Hernia Repair Does Not Reduce 30-Day Wound Complications

2016 ◽  
Vol 223 (4) ◽  
pp. S59
Author(s):  
Christina M. Papageorge ◽  
Benjamin K. Poulose ◽  
Sharon E. Phillips ◽  
Luke M. Funk ◽  
Michael J. Rosen ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Fascial Closure ◽  
Wound Complications ◽  
Primary Fascial Closure

scholarly journals Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

BMJ ◽  
2020 ◽  
pp. m2457 ◽  
Author(s):  
Oscar A Olavarria ◽  
Karla Bernardi ◽  
Shinil K Shah ◽  
Todd D Wilson ◽  
Shuyan Wei ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Ventral Hernia Repair ◽  
Controlled Trial ◽  
Emergency Department Visits ◽  
Laparoscopic Ventral Hernia Repair ◽  
Wound Complications ◽  
Robotic Ventral Hernia Repair

AbstractObjectiveTo determine whether robotic ventral hernia repair is associated with fewer days in the hospital 90 days after surgery compared with laparoscopic repair.DesignPragmatic, blinded randomized controlled trial.SettingMultidisciplinary hernia clinics in Houston, USA.Participants124 patients, deemed appropriate candidates for elective minimally invasive ventral hernia repair, consecutively presenting from April 2018 to February 2019.InterventionsRobotic ventral hernia repair (n=65) versus laparoscopic ventral hernia repair (n=59).Main outcome measuresThe primary outcome was number of days in hospital within 90 days after surgery. Secondary outcomes included emergency department visits, operating room time, wound complications, hernia recurrence, reoperation, abdominal wall quality of life, and costs from the healthcare system perspective. Outcomes were pre-specified before data collection began and analyzed as intention to treat.ResultsPatients from both groups were similar at baseline. Ninety day follow-up was completed in 123 (99%) patients. No evidence was seen of a difference in days in hospital between the two groups (median 0 v 0 days; relative rate 0.90, 95% confidence interval 0.37 to 2.19; P=0.82). For secondary outcomes, no differences were noted in emergency department visits, wound complications, hernia recurrence, or reoperation. However, robotic repair had longer operative duration (141 v 77 min; mean difference 62.89, 45.75 to 80.01; P≤0.001) and increased healthcare costs ($15 865 (£12 746; €14 125) v $12 955; cost ratio 1.21, 1.07 to 1.38; adjusted absolute cost difference $2767, $910 to $4626; P=0.004). Among patients with robotic ventral hernia repair, two had an enterotomy compared none with laparoscopic repair. The median one month postoperative improvement in abdominal wall quality of life was 3 with robotic ventral hernia repair compared with 15 following laparoscopic repair.ConclusionThis study found no evidence of a difference in 90 day postoperative hospital days between robotic and laparoscopic ventral hernia repair. However, robotic repair increased operative duration and healthcare costs.Trial registrationClinicaltrials.gov NCT03490266.

Reconstruction of the Abdominal Wall with Mesh II: Ventral Hernia Repair

2020 ◽  
Author(s):  
Samuel W. Ross ◽  
B. Todd Heniford ◽  
Vedra A. Augenstein
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Clinical Outcomes ◽  
Ventral Hernia Repair ◽  
Abdominal Wall Reconstruction ◽  
Surgical Techniques ◽  
Patient Specific ◽  
Wound Complications ◽  
Robotic Hernia Repair

Incisional and Ventral hernia repair (VHR) is one of the most common surgical procedures in the world, and over the last two decades this field has enjoyed exponentially advances thanks to improvements in operative technique and biomechanical science. Truly complex hernias which are multiply recurrent, have active infections, loss of domain, presence of stomas, require component separation or panniculectomy, or have other exacerbating factors are truly challenging to manage operatively, and the multidisciplinary operations to repair them have become known collectively as abdominal wall reconstruction (AWR). Herein, we describe the surgical history of AWR, the current state of surgical techniques and mesh science, as well as novel areas for advancement of the field in the future. In particular, a focus on patient specific clinical outcomes such as hernia recurrence, wound complications, and quality of life has been made with regards to mesh position and selection. Our goal is to provide a comprehensive review of the state of the literature and our recommendations for AWR, for the Plastic, General, and Hernia surgeon alike. This review contains 7 figures, 3 tables, and 79 references. Keywords: ventral hernia repair, incisional hernia, abdominal wall reconstruction, mesh, pre-peritoneal hernia repair, pre-operative optimization, clinical outcomes, mesh position, surgical site infection, robotic hernia repair

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