Assessing complications and cost-utilization in ventral hernia repair utilizing biologic mesh in a bridged underlay technique - 20/03/15
Abstract |
Background |
The inability to reapproximate fascia in complex ventral hernia (CVH) repair remains challenging. Single-stage bridging reconstructions have been reported, however, with high rates of recurrence and wound complications. We describe a single-surgeon experience with bridging biologic CVH repair.
Methods |
We reviewed 37 patients undergoing CVH repair with bridging biologic mesh by the senior author from January 1, 2007 to January 1, 2013. Surgical history and operative characteristics were analyzed for predictors of hernia recurrence and wound complications.
Results |
Average age was 53 ± 15 years, body mass index was 31.1 ± 8.1 kg/m2, and history of prior repair in 18 patients. Common indications were trauma, intra-abdominal infection, and prior intra-abdominal surgery. Incidence of wound complications was 51.4%, most commonly wound breakdown and infection. With average follow-up of 13 months, recurrence rate was 18.9% at an average of 8.2 months postoperatively. Analysis demonstrated postoperative wound infection as the only predictor of recurrence (odds ratio = 22.1, P = .017).
Conclusions |
Hernia recurrence rate was 18.9% with bridged biologic CVH repairs, strongly associated with postoperative wound infection. This suggests that patients with postoperative infections may benefit from closer surveillance and more aggressive wound management.
Le texte complet de cet article est disponible en PDF.Keywords : Abdominal wall reconstruction, Biologic mesh, Complex ventral hernia repair, Surgical complications, Acellular dermal matrix, Cost utilization
Plan
| Presentation history: The data included in this manuscript have not been presented or published elsewhere. |
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| Institutional review board: This study was reviewed and approved by the institutional review board at the Hospital of the University of Pennsylvania. |
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| Funded by the Department of Surgery of the Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania. |
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| The authors declare no conflicts of interest. |
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| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
Vol 209 - N° 4
P. 695-702 - avril 2015 Retour au numéro
Article précédent
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