Single-Institution Experience With Component Separation for Ventral Hernia Repair: A Retrospective Review. (June 2018)

• Record Type: Journal Article
• Authors: Hill, Brian; Kambeyanda, Rohan; Fewell, Donna; Bryant, Stewart; Delaney, Kevin O.; Herrera, Fernando A.
• Is Part Of: Annals of plastic surgery. Volume 80(2018)Supplement 6 6S
• Publication Date: 2018-06
• Subjects: abdominal wall reconstruction -- complex ventral hernia -- component separation; Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/SAP.0000000000001349
• Languages: English
• ISSNs: 0148-7043

Abstract

Abstract : Purpose: In this study, we reviewed our institution's experience using component separation for repair of ventral hernias. Methods: This was a retrospective review of all component separations for ventral hernia between July 2009 and December 2015. Recorded data included body mass index (BMI), preoperative albumin, smoking history, comorbidities, additional procedures, length of surgery, hospitalization, recurrence, and postoperative complications. Results: One hundred ninety-six component separations were performed in the study period. The average patient age was 56 years, and 65.3% of patients were female. The average BMI was 32.6 kg/m 2 ; preoperative albumin was 3.59; 18.4% were current smokers; 28.1% were diabetic; and 14.3% had heart disease. Postoperative complications developed in 16.8% of patients. Recurrence developed in 8.7% of patients. Patients who developed a postoperative complication had a higher BMI ( P = 0.025) and lower albumin ( P = 0.047) compared with patients who did not develop complications. Current smokers were more likely to develop complications ( P = 0.008). More than one third of patients had additional procedures at the time of the ventral hernia repair. The addition of a plastic surgery procedure was not associated with an increased risk of developing a complication ( P = 0.25). Patients who developed complications had a significantly longer hospital course ( P < 0.001) but no difference in total operative time ( P = 0.975). Increased number of comorbidities did not statistically correlate with an increased complication rate ( P = 0.65) or length of hospital stay ( P = 0.43). Conclusions: We identified risk factors that increase the likelihood of postoperative complications and length of hospital stay. In addition, this study suggests that more comorbidities and additional procedures at the time of the hernia repair may not have as large of impact on complication risk as previously thought.