title: Repair of large complex recurrent incisional hernias with retromuscular mesh and panniculectomy.
abstract: BACKGROUND
  Recurrent incisional hernia repair is associated with high recurrence and wound complication rates.
  
  
  METHODS
  The clinical courses of patients who underwent recurrent incisional hernia repair via retromuscular mesh placement with concomitant panniculectomy at a university teaching hospital from 1999 to 2004 were reviewed retrospectively. Postoperative evaluation included a quality of life survey.
  
  
  RESULTS
  Forty-seven patients (13 male, 34 female) with an average body mass index of 34.4 kg/m2, an average midline hernia defect of 31.4 cm, and at least 1 and on average 2.5 previous repair attempts underwent hernia repair. Wound infections occurred in 4 patients (8%) and seromas requiring aspiration occurred in 1 patient (2%). Four patients (8%) had re-recurrences of their hernias. All patients rated the postoperative appearance of their abdomen as at least satisfactory.
  
  
  CONCLUSIONS
  Recurrent incisional hernia repair with a retromuscular mesh and panniculectomy has low recurrence and wound complication rates and excellent patient satisfaction.
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, University of Pennsylvania School of Medicine, 3400 Spruce St, Philadelphia, PA 19104, USA. berry037@mc.duke.edu
authors.forename: Mark F
authors.initials: MF
authors.lastname: Berry
authors.forename: Sonya
authors.initials: S
authors.lastname: Paisley
authors.forename: David W
authors.initials: DW
authors.lastname: Low
authors.forename: Ernest F
authors.initials: EF
authors.lastname: Rosato
mesh_terms: D050153:Abdominal Fat / Q000601:surgery*; D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D013536:Suture Techniques; D016896:Treatment Outcome