Complex Abdominal Wall Reconstruction in Neutropenic Patients

2021 ◽  
pp. 000313482110110
Author(s):  
Kajmolli Agon ◽  
Smiley Abbas ◽  
McGuirk Matthew ◽  
Gachabayov Mahir ◽  
Bodin Roxana ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Fatty Liver Disease ◽  
Abdominal Wall Reconstruction ◽  
Case Series ◽  
Transversus Abdominis ◽  
Site Infection ◽  
Transversus Abdominis Release ◽  
Nonalcoholic Fatty Liver ◽  
Neutropenic Patients

The aim of our study was to determine whether patients with neutropenia (absolute neutrophil count (ANC) ≤1,500 cells/µL) had higher rates of surgical site infection after elective abdominal wall reconstruction. This was a case series from a prospective complex abdominal wall reconstruction cohort describing the surgical outcomes of 4 neutropenic patients (ANC ≤1,500 cells/µL) within 48 hours of index operation. Median age was 55 years, 3 patients were female. All patients had liver cirrhosis as a comorbidity: 2 patients as a result of alcohol abuse and 2 patients secondary to cryptogenic and nonalcoholic fatty liver disease, respectively. All patients underwent a posterior component separation with transversus abdominis release and retro-rectus biologic mesh. None of the 4 patients developed a surgical site infection 90 days postoperatively. Complex abdominal wall reconstruction in neutropenic patients could be safe.

scholarly journals Transversus Abdominis Release (TAR) Procedure: Experience of An Abdominal Wall Reconstruction Group.

2021 ◽  
Author(s):  
Alberto Ricaurte ◽  
Carlos Rey ◽  
Felipe Giron ◽  
Danny Conde ◽  
Lina Rodriguez ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Transversus Abdominis ◽  
High Morbidity ◽  
Abdominal Wall Defects ◽  
Site Infection ◽  
Emergency Scenarios ◽  
Clinical Conditions ◽  
Reconstruction Group

Abstract BackgroundComplex abdominal wall defects are important conditions with a high morbidity, leading to impairment of patients physical condition and quality of life. In the last decade, the abdominal wall reconstruction paradigm has changed due to formation of experienced and excellence groups, improving clinical outcomes after surgery. Therefore, our study shows the perspective and outcomes of an abdominal wall reconstruction group (AWRG) in Colombia, focused on transverse abdominis release (TAR) procedure.MethodsA retrospective review of a prospectively collected database was conducted. All the patients older than 18 years old that underwent TAR procedure between January 2014 – December 2020 were included. Analysis and description of postoperative outcomes (recurrence, surgical site infection (SSI), seroma, hematoma, and re-intervention) was performed.Results50 patients underwent TAR procedure. 62% of patients were male. Mean age was 55 ± 13.4 years. Mean BMI was 27.8 ± 4.5 Kg/m2. Abdominal wall defects were classified with EHS ventral Hernia classification having a W3 hernia in 72% of all defects (Mean gap size of 11.49 cm ± 4.03 cm). Mean CeDAR preoperative risk score was 20.5 % ± 14.5%. Protective association was established for SSI if the procedure was performed by the AWRG OR 0.7 (IC 95% 0.05-0.93 ). Higher risk of SSI was found in cases not performed by the abdominal wall reconstruction group OR 13.6 (CI 95% 9.12 - 15.5 ). ConclusionsTAR procedure for complex abdominal wall defects under specific clinical conditions including emergency scenarios is viable. Specialized and experienced groups lessen surgical site infection.

Systematic review of transversus abdominis release in complex abdominal wall reconstruction

Hernia ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 5-15 ◽  
Author(s):  
J. A. Wegdam ◽  
J. M. M. Thoolen ◽  
S. W. Nienhuijs ◽  
N. de Bouvy ◽  
T. S. de Vries Reilingh
Keyword(s):  
Systematic Review ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Transversus Abdominis ◽  
Transversus Abdominis Release

Increased incidence of surgical site infection with a body mass index ≥ 35 kg/m2 following abdominal wall reconstruction with open component separation

2018 ◽  
Vol 33 (8) ◽  
pp. 2503-2507 ◽  
Author(s):  
Salvatore Docimo ◽  
Konstantinos Spaniolas ◽  
Michael Svestka ◽  
Andrew T. Bates ◽  
Samer Sbayi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Body Mass ◽  
Abdominal Wall Reconstruction ◽  
Component Separation ◽  
Site Infection

The Impact of Mesh Reinforcement with Components Separation for Abdominal Wall Reconstruction

2018 ◽  
Vol 84 (6) ◽  
pp. 959-962 ◽  
Author(s):  
Seyed Amirhossein Razavi ◽  
Karan A. Desai ◽  
Alexandra M. Hart ◽  
Peter W. Thompson ◽  
Albert Losken
Keyword(s):  
Postoperative Complications ◽  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Recurrence Rate ◽  
Abdominal Wall Reconstruction ◽  
Abdominal Hernia ◽  
Fascial Closure ◽  
Site Infection ◽  
Components Separation ◽  
The Impact

The goal in abdominal wall reconstruction (AWR) is to minimize morbidity and prevent hernia recurrence. Components separation and mesh reconstruction are two options, however, with advantages and disadvantages. The purpose of this review was to investigate outcomes in patients with abdominal wall hernia undergoing primary closure with component separation (CS) versus CS with acellular dermal matrix (ADM) reinforcement (CS + mesh). Medical records of consecutive patients who underwent abdominal wall reconstruction using CS with or without ADM reinforcement were retrospectively reviewed. Primary fascial closure was achieved in all patients. ADM reinforcement when used was performed using the underlay technique. Reconstructive technique and postoperative complications including delayed healing, skin necrosis, fistula, seroma, hematoma and surgical site infection, recurrence, and reoperation were recorded. Comparisons between the two groups were assessed. One hundred and seven patients were included (mean age, 55.7; 51.4% male; median follow-up 297 days). Twenty-six patients (24%) underwent CS alone; whereas 81 patients (76%) CS + mesh placement. Patient comorbidities, including smoking (26%), diabetes (20%), and hypertension (46%); body mass index (mean 32.3 ± 7.6); and albumin level on the day of surgery (mean 3.4 ± 0.5 mg/dL) were not significantly different between groups. Surgical site infection was significantly higher among CS + mesh patients (22.2%) versus CS only patients (3.9%) (P = 0.02). The recurrence rate of abdominal hernia was significantly lower in CS + mesh patients compared with CS only (14.8% vs 34.6%; P = 0.02). No significant differences in other postoperative complications were identified between the two groups. ADM reinforcement at the time of components separation is often selected in more complex, higher risk patients. Although the incidence of infection was higher in these patients, it was usually treated without mesh removal and recurrence rate was significantly lower when compared to CS alone.

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