title: Preoperative risk reduction: strategies to optimize outcomes.
abstract: The success of hernia repair is measured by absence of recurrence, appearance of the surgical scar, and perioperative morbidity. Perioperative surgical site occurrence (SSO), defined as infection, seroma, wound ischemia, and dehiscence, increases the risk of recurrent hernia by at least 3-fold. The surgeon should optimize all measures that promote healing, reduce infection, and enhance early postoperative recovery. In the population with ventral hernia, the most common complication in the immediate perioperative period is surgical site infection. This article reviews several preoperative measures that have been reported to decrease SSOs and shorten length of hospital stay.
authors.affiliation: Division of General Surgery, Department of Surgery, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, L223A, Portland, OR 97239, USA. Electronic address: martindr@ohsu.edu.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Martindale
authors.forename: Clifford W
authors.initials: CW
authors.lastname: Deveney
mesh_terms: D019072:Antibiotic Prophylaxis; D000985:Antisepsis; D004032:Diet; D006555:Hernia, Ventral / Q000150:complications / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000517:prevention & control; D018529:Nutritional Support; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention; D016540:Smoking Cessation; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control
keywords: Hernia repair; Intervention; Obesity; Perioperative morbidity; Surgical site infection