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Assessing the Utility of the CeDAR App in Risk Reduction for Complex Ventral Hernia Repair

C. Lendon Mullens, Mihail Climov, Miles J. Graves, Jon S. Cardinal, A. Corde Mason
West Virginia University
2018-01-14

Presenter: C. Lendon Mullens

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The submitting and presenting author of the work for this project has been predominately been accomplished through their efforts. He conceived and developed the majority of the study design with assistance of the faculty and resident co-authors, acquired most, analyzed all and interpreted all data and was responsible for the majority of drafting the abstract text with the assistance and guidance of the more senior authors on the abstract.

Director Name: Aaron C. Mason

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction: Complex ventral hernia repair is fraught with postoperative wound-related morbidity and hernia recurrence. CeDAR is a smartphone application that computes a prediction for risk of wound-related complications in complex ventral hernia patients. This study analyzed postoperative outcomes of patients who underwent component separation repair with placement of a biosynthetic mesh.

Methods: Twenty-two patients were found to meet inclusion criteria for this retrospective study. CeDAR was used in all patient evaluations for education and risk reduction.

Results: Average postoperative follow up of the twenty-two-patient cohort was 14.7 months. Five of our patients (23%) developed wound related collections, two of which were infected. Interestingly, three patients developed pulmonary emboli, each of whom had an associated body mass index (BMI) greater than 33. The realized rate of wound related complications in our twenty-two-patient cohort (23%) was found to be much lower than the average predicted wound complication risk score according to the CeDAR app (47%).

Conclusion: Retrospective analysis of our patient population revealed a lower than expected rate of post-surgical complication when compared to said population's mean CeDAR app risk score. We postulate that this improvement observed in our patient outcomes may be attributed, in part, to additional nutritional assessment standards required of our patients prior to operating. Additionally, we identified a subgroup of patients with higher BMI's who developed pulmonary embolism, which underscores the importance of strict adherence to weight reduction in order to minimize overall complications.

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