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Abdominal Wall Hernias: Emergency Ventral Hernia Repair

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Common Problems in Acute Care Surgery

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Abstract

The number of patients presenting acutely due to complications from a ventral hernia is increasing. Complications may include incarceration, bowel obstruction, strangulation, acute worsening of pain, and skin rupture with associated ascites leak. Emergency ventral hernia repair is associated with worse outcomes than elective repair due to increased severity of patient comorbidities; acute inflammation and contamination; and metabolic, electrolyte, and nutritional disturbances. These factors present a unique set of challenges for surgeons treating an already complex disease. Surgeons must decide whether to perform a limited or definitive repair and carefully consider the surgical techniques they utilize as advanced techniques may be less effective and pose greater risk in the acute setting. Additional challenges include patients with cirrhosis, pregnancy, fascial dehiscence from a recent surgery, or an open abdomen. Perioperative management strategies to consider include the use of a nasogastric tube, pain management, early nutritional support, abdominal binders, and drain utilization/management.

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Authors and Affiliations

  1. Department of Surgery, University of Texas Health Science Center at Houston, 6431 Fannin St., MSB 5.254, Houston, TX, 77030, USA

    Julie L. Holihan & Mike K. Liang

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  1. Julie L. Holihan
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  2. Mike K. Liang
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Correspondence to Mike K. Liang .

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Editors and Affiliations

  1. Department of Surgery, The University of Texas McGovern Medical School - Houston, Houston, Texas, USA

    Laura J. Moore

  2. General Surgery and Trauma Ben Taub Hospital, Houston, Texas, USA

    S. Rob Todd

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Holihan, J.L., Liang, M.K. (2017). Abdominal Wall Hernias: Emergency Ventral Hernia Repair. In: Moore, L., Todd, S. (eds) Common Problems in Acute Care Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-42792-8_37

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  • DOI: https://doi.org/10.1007/978-3-319-42792-8_37

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