North Pacific Surgical AssociationOutcomes of the fascial component separation technique with synthetic mesh reinforcement for repair of complex ventral incisional hernias in the morbidly obese
Section snippets
Methods
A prospectively maintained database of all patients undergoing ventral incisional hernia (VIH) repair from June 1996 to May 2007 was reviewed after Institutional Review Board approval. Patients undergoing fascial component separation with prosthetic mesh reinforcement and a body mass index (BMI) greater than 30 mg/m2 were included in the current study. The data were obtained from a single community surgical practice. Patient demographics and hernia characteristics are listed in Table 1.
All
Results
The 90 patients included in the study have been followed for a mean of 50 months (range 1–132). Mean operative time was 92 minutes (range 41–255) with a mean blood loss of 60 mL. There were no intraoperative complications and no patients required blood transfusion. Five patients had combined intra-abdominal procedures. Mean length of stay was 3.4 days (range 0–38).
The most prevalent complications were wound-related. Superficial skin closure issues affected 8 (9%) patients and deep infections
Comments
Repair of incisional hernias is a common procedure confronting the practicing general surgeon. Etiologic factors are multiple but are substantially influenced by preoperative comorbidities, BMI, perioperative infection, and hernia size.13 Obesity is a major contributing factor in the initial development of a hernia and a major predictor for the likelihood of recurrence after an operative repair.14, 15 The widespread application of mesh based repairs has dramatically reduced recurrence rates
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