title: The Use of Mesh in Emergent Ventral Hernia Repair: Effects on Early Patient Morbidity and Mortality.
abstract: The long-term recurrence rate of ventral hernia repair is 20-50 %, with a higher rate of recurrence in cases that do not use mesh. Previous teachings have cautioned against the use of mesh in contaminated wounds. Therefore, emergent ventral hernia repair is often performed without the use of mesh. Our aim is to determine if mesh is used in these cases and its effect on 30-day wound-related morbidity using the American College of Surgeons National Surgery Quality Improvement Program database.
  
  
  
  All emergency ventral hernia repairs performed from 2005 to 2013 were identified. The effect of mesh on postoperative morbidity and mortality was investigated. Significance was defined as p < 0.05.
  
  
  
  A total of 2449 patients met inclusion criteria. The use of mesh was associated with a significantly longer operative time for all wound classes and increased risk of return to the operating room in contaminated cases. Patients who returned to the operating room did not return to the OR for mesh or hernia-related complications.
  
  
  
  Emergency ventral hernia repair with mesh can be safely performed without an increase in wound-related or additional 30-day patient morbidity or mortality. Additional studies are needed to determine the long-term outcomes of mesh utilization in this cohort.
authors.affiliation: Department of Surgery, The George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC, 20037, USA. ihaskins@gwu.edu.
authors.forename: Ivy N
authors.initials: IN
authors.lastname: Haskins
authors.affiliation: Department of Surgery, The George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC, 20037, USA.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Amdur
authors.affiliation: Department of Surgery, The George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC, 20037, USA.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lin
authors.affiliation: Department of Surgery, The George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC, 20037, USA.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Vaziri
mesh_terms: D016208:Databases, Factual; D004630:Emergencies; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D006801:Humans; D009017:Morbidity; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D058996:Quality Improvement; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000453:epidemiology*; D016896:Treatment Outcome
keywords: Emergency; Mesh; NSQIP; Ventral hernia repair; Wound class