title: Complex Abdominal Wall Reconstruction: A Novel Approach to Postoperative Care Using Physical Medicine and Rehabilitation.
abstract: BACKGROUND
  Abdominal wall defects remain a significant cause of morbidity and mortality in the United States. Postoperative rehabilitation programs have been used consistently in many surgical subspecialties with exceptional results. Such programs have proven to decrease the total time patients require to resume daily activities. The authors describe a systematic rehabilitation protocol developed with the physical medicine and rehabilitation department that has significantly decreased recurrence rates in patients undergoing complex abdominal wall reconstruction.
  
  
  METHODS
  A retrospective analysis was carried out on patients presenting for open repair of an abdominal wall defect performed by a single surgeon. Over a 5-year period, there were 275 consecutive patients divided into two similar groups: one group consisted of 137 patients that received abdominal wall rehabilitation; a second group of 138 patients did not. Patient demographics including body mass index, number of hernia defects, number of previous repairs/abdominal operations, defect size, operative time, blood loss, and postoperative complications including recurrence were collected.
  
  
  RESULTS
  Patients enrolled in the abdominal wall rehabilitation program were found to have fewer recurrences at follow-up, with statistical significance compared with those that were not enrolled in the program.
  
  
  CONCLUSIONS
  The implementation of the abdominal wall rehabilitation program has resulted in a decrease in recurrence rates following complex abdominal wall hernia repair and reconstruction. This is an innovative system that uses rehabilitation and physical therapy to enhance the psychosocial and occupational status of patients by improving recurrence rates.
  
  
  METHODS
  Therapeutic, III.
authors: Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors: Ronnie A
authors: RA
authors: Pezeshk
authors: Benson J
authors: BJ
authors: Pulikkottil
authors: Steven
authors: S
authors: Mapula
authors: Nathaniel E
authors: NE
authors: Schaffer
authors: Lori
authors: L
authors: Yap
authors: Kelly
authors: K
authors: Scott
authors: Patricia
authors: P
authors: Gordon
authors: Ronald E
authors: RE
authors: Hoxworth
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000534:rehabilitation / Q000601:surgery*; D059685:Herniorrhaphy / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011182:Postoperative Care / Q000379:methods*; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome