Risk factors associated with early failure in complex abdominal wall reconstruction: a 5 year single surgeon experience.
Complex abdominal wall reconstruction (AWR) is commonly performed, but with a significant rate of surgical complications and hernia recurrence. The aim of this experiential review is to assess risk factors for hernia recurrence after complex AWR. A retrospective review of AWR patients from 2007-2012 was performed. Rates of hernia recurrence were assessed. Univariate analyses and subsequent multivariate logistic regression analysis was used to assess independent predictors of early hernia recurrence. One hundred and thirty-four consecutive cases of AWR were performed over a 5-year period. Hernia recurrence developed in 14 (10.4%) patients. Hernias derived from trauma (OR = 19.76, p = 0.011) and those who experienced postoperative wound infections (OR = 18.81, p = 0.004) were at increased risk for hernia recurrence. In conclusion, increased vigilance must be paid to patients presenting after trauma with massive loss of domain and those who experience postoperative infection, as these cohorts are at added risk for failed reconstruction.
Division of Plastic Surgery, Hospital of the University of Pennsylvania , Philadelphia, PA , USA.
Jason D
JD
Wink
Ari M
AM
Wes
John P
JP
Fischer
Jonas A
JA
Nelson
Carrie
C
Stranksy
Stephen J
SJ
Kovach
D000328:Adult; D005260:Female; D006555:Hernia, Ventral / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D017211:Treatment Failure
Component separation; abdominal wall reconstruction; hernia recurrence; ventral hernia repair