title: Survey on ventral hernias: surgeon indications, contraindications, and management of large ventral hernias.
abstract: Repair of ventral hernias constitutes one of the most common surgical procedures. Although an abundance of data exists on objective outcome measures, very little information exists on subjective measures of surgeon preference and patient satisfaction in surgical management of ventral  hernias. Moreover, there are minimal data on indications for elective repair of ventral hernias. Two questionnaires were sent to a population of general and plastic surgeons active in hernia surgery. The first of these aimed at gathering information from surgeons about their indications and  contraindications for repair of ventral hernias. The second survey was aimed at determining surgeons' perception of patient satisfaction with repair of large ventral hernias (greater than 15 cm width). Five hundred sixty-eight surgeons responded to the first survey and 336 responded to the  second survey. The most common indications for elective repair of abdominal wall hernias were generalized pain (68.7%) and cosmesis (54.6%), whereas the most common contraindications were morbid obesity (43.3%), American Society of Anesthesiologists Class III or IV (35.4%), and enterocutaneous  fistula (33.1%). The majority of surgeons do not routinely repair large abdominal wall hernias in asymptomatic patients, but 31.6 per cent do repair asymptomatic large hernias. Most surgeons reported that the majority of patients had resolution of pain and subjective impression of improved  cosmesis after surgery. This study demonstrates uniform indications and contraindications for surgical repair of ventral hernias among surgeons as well as surgeons' perception of improvements in satisfaction of most patients after surgery. Future studies will focus on comparing surgeon and  patient satisfaction.
authors.affiliation: Department of Plastic Surgery, Georgetown University Hospital, Washington, DC, USA. karenkim90@me.com
authors.forename: Karen Kim
authors.initials: KK
authors.lastname: Evans
authors.forename: Harvey
authors.initials: H
authors.lastname: Chim
authors.forename: Ketan M
authors.initials: KM
authors.lastname: Patel
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Salgado
authors.forename: Samir
authors.initials: S
authors.lastname: Mardini
mesh_terms: D001291:Attitude of Health Personnel; D000075202:Contraindications; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D013502:General Surgery; D019538:Health Care Surveys; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000706:statistics & numerical data*; D006801:Humans; D017060:Patient Satisfaction; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013518:Surgery, Plastic; D011795:Surveys and Questionnaires