scholarly journals A Comparison of Short Term Outcomes Following Abdominal Wall Hernia Repair Based on Pre-Operative Functional Health Status

2011 ◽  
Vol 140 (5) ◽  
pp. S-1028
Author(s):  
Emily Albright ◽  
John S. Roth ◽  
Daniel L. Davenport
Keyword(s):  
Health Status ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Functional Health ◽  
Functional Health Status ◽  
Short Term ◽  
Abdominal Wall Hernia Repair

Outcome of Abdominal Wall Hernia Repair with Biologic Mesh: Permacol™ versus Strattice™

2014 ◽  
Vol 80 (10) ◽  
pp. 999-1002 ◽  
Author(s):  
Amy W. Cheng ◽  
Maher A. Abbas ◽  
Talar Tejirian
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Hernia Recurrence ◽  
Biologic Mesh ◽  
Abdominal Hernia ◽  
Complication Rates ◽  
Short Term ◽  
Porcine Dermis ◽  
Abdominal Wall Hernia Repair

The use of biologic mesh in abdominal wall operations has gained popularity despite a paucity of outcome data. Numerous biologic products are available with virtually no clinical comparison studies. A retrospective study was conducted to compare patients who underwent abdominal wall hernia repair with Permacol™ (crosslinked porcine dermis) and Strattice™ (noncrosslinked porcine dermis). Of 270 reviewed patients, 195 were implanted with Permacol™ and 75 with Strattice™. Ventral hernia repairs comprised the majority (85% for Permacol, 97% for Strattice™). Postoperative infection rate was lower in the Strattice™ group (5 vs 21%, P < 0.01). In the Permacol™ group only, the overall complication rates were significantly higher in patients with infected versus clean wounds (55 vs 35%, P < 0.05) and in obese patients (body mass index 40 kg/m2 or greater [57 vs 34%], P < 0.01). Short-term complication and recurrence rates were higher when mesh was used as a fascial bridge: 51 versus 28 per cent for Permacol™, 58 versus 20 per cent for Strattice™. The hernia recurrence was similar in both groups. In this review of patients undergoing abdominal hernia repair with biologic mesh, Strattice™ mesh was associated with a lower short-term complication rate compared with Permacol™, but the hernia recurrence rate was similar.

Preoperative Functional Health Status Impacts Outcomes after Ventral Hernia Repair

2012 ◽  
Vol 78 (2) ◽  
pp. 230-234 ◽  
Author(s):  
Emily L. Albright ◽  
Daniel L. Davenport ◽  
J. Scott Roth
Keyword(s):  
Health Status ◽  
Hernia Repair ◽  
Functional Status ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Functional Health ◽  
Functional Health Status ◽  
Short Term ◽  
Acs Nsqip ◽  
Acs Nsqip Database

Associated with the aging population is an increase in comorbidities and a decrease in the ability to perform basic daily activities. This is tracked within the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) as a patient's preoperative functional health status. Our goal was to evaluate the impact of preoperative functional status upon outcomes after ventral hernia repair. We reviewed all cases of patients that underwent ventral hernia repair from 2005 to 2010 in the ACS-NSQIP database. Patients were identified based on selected Current Procedural Terminology codes and grouped based on functional status as listed in the ACS-NSQIP database—independent, partially dependent, and totally dependent. Preoperative and operative variables were recorded for all patients. Clinical risk factors and short-term outcomes between groups were compared. Multivariable logistic regression was used to adjust for age, wound class, American Society of Anesthesiologists class, and case relative value units. A total of 76,397 patients were identified: 74,785 were independent (97.9%), 1,317 partially dependent (1.7%), and 295 totally dependent (0.4%). Totally dependent patients had an increased risk for all short-term outcomes after ventral hernia repair: wound occurrence, pneumonia, pulmonary embolism, urinary tract infection, myocardial infarction, deep venous thrombosis, sepsis, return to the operating room, and death ( P < 0.001 for all).

scholarly journals Commentary: Evidence for Replacement of an Infected Synthetic by a Biological Mesh in Abdominal Wall Hernia Repair

2017 ◽  
Vol 4 ◽  
Author(s):  
Ekaterini Christina Tampaki ◽  
Athanasios Tampakis ◽  
Konstantinos Kontzoglou ◽  
Gregory Kouraklis
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Biological Mesh ◽  
Abdominal Wall Hernia Repair

Impact of a Body Mass Index Threshold on Abdominal Wall Hernia Repair at a Safety-Net Hospital

2021 ◽  
pp. 000313482110475
Author(s):  
Tayler J James ◽  
Lauren Hawley ◽  
Li Ding ◽  
Evan T Alicuben ◽  
Kamran Samakar
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Body Mass ◽  
Abdominal Wall Hernia ◽  
Safety Net ◽  
Obese Patients ◽  
Optimization Strategy ◽  
Elective Group ◽  
Abdominal Wall Hernia Repair

Background Body mass index (BMI) thresholds are utilized as a preoperative optimization strategy for obese patients prior to elective abdominal wall hernia repair. The objectives of this study were to determine the proportion of patients at our institution who ultimately underwent hernia repair after initial deferral due to BMI and to evaluate outcomes of those who required emergent repair during the deferral period. Methods A retrospective review was performed from 2016 to 2018 to identify all patients with abdominal wall hernias who were deferred surgery due to BMI. Patient characteristics, hernia type, change in BMI, progression to surgery, acuity of surgery (elective or emergent), and postoperative outcomes were examined. Results 200 patients were deferred hernia repair due to BMI. Of these, 150 (75%) did not undergo repair over a mean period of 27 months. The remaining 50 patients ultimately underwent repair, 36 of which (72%) were elective and 14 (28%) emergent. The mean initial BMI of the elective group was 35.3 ± 1.8, compared to 39.1 ± 5.3 in the no surgery group and 40.6 ± 8.2 in the emergent group ( P < .01). While the elective group lost weight before surgery, the other groups did not. Patients who required emergent surgery had worse outcomes than those repaired electively. Conclusions Preoperative weight loss is unsuccessful in most obese patients presenting for abdominal wall hernia repair at our institution. Patients who required emergent hernia repair had worse outcomes than those who underwent elective repair. Our institution’s BMI threshold is a failed optimization strategy that needs to be reconsidered.

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