Total Abdominal Wall Reconstruction with Component Separation, Reinforcement, and Vertical Abdominoplasty in Patients with Complex Ventral Hernias
| Autor: | Antonio Espinosa-de-los-Monteros, Luis Alfonso Martin-del-Campo, Zeniff Gómez-Arcive, Héctor Avendaño-Peza, Jose-Adolfo Navarro-Navarro |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030230 surgery Risk Assessment Severity of Illness Index Cohort Studies Abdominal wall Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Recurrence Tensile Strength medicine Humans Hernia Aged Retrospective Studies Wound Healing Abdominoplasty business.industry Mortality rate Abdominal Wall Middle Aged Plastic Surgery Procedures Surgical Mesh Prognosis medicine.disease Hernia Ventral Surgery Exact test Plastic surgery Treatment Outcome Surgical mesh medicine.anatomical_structure 030220 oncology & carcinogenesis Mann–Whitney U test Female business |
| Zdroj: | Aesthetic Plastic Surgery. 40:387-394 |
| ISSN: | 1432-5241 0364-216X |
| DOI: | 10.1007/s00266-016-0628-7 |
| Popis: | Large complex ventral hernias act as tissue expanders for skin and subcutaneous fat. The purpose of this study is to evaluate outcomes of total abdominal wall reconstruction with component separation, posterior reinforcement, and vertical abdominoplasty in patients with large complex ventral hernias. Between 2010 and 2014, 58 patients underwent total abdominal wall reconstruction with component separation, intra-abdominal reinforcement, and vertical abdominoplasty. Between 2010 and 2012, patients underwent the conventional technique of component separation, while a perforator-preserving technique was performed during 2013 and 2014. Reinforcement material used was either synthetic mesh in clean cases or biologic mesh if contamination was present. All of the excessive skin and subcutaneous fat was removed in a vertical fashion. Data were analyzed with Mann–Whitney’s U test or Fisher’s exact test, as indicated. There were 27 moderately complex and 31 majorly complex hernias. Mean hernia size was 16 × 12 cm. The mean size of the removed skin island was 21 × 12 cm. Patients with contamination during the repair had longer in-hospital stays. Overall the local wound complication rate was 24 %, and was lower with the perforator-preserving technique compared to the conventional technique of component separation (11 vs. 48 %; OR 0.13, CI 0.03–0.5; p = 0.003). The overall postoperative morbidity rate was higher in the presence of contamination, and in patients with lower preoperative serum albumin levels. Mean total follow-up was 14 months with a 1-year recurrence-free survival of 96 %. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . |
| Databáze: | OpenAIRE |
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