<< Back to the abstract archive
A Single Surgeon's 7 Year Experience With Abdominal Wall Reconstruction
Abraham A. Williams, BS
Jonathan P. Brower, MD
Mehmet C. Uluer, MD, ScM
Jeffrey A. Gusenoff, MD
University of Pittsburgh
2021-01-31
Presenter: Abraham A. Williams, BS
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.
Director Name: Vu T. Nguyen, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Purpose
Abdominal wall reconstruction with component separation (CS) is an essential technique for treating complicated ventral hernias. The incorporation of biologic mesh is thought to strengthen the repair, while conferring resistance to infection relative to its synthetic counterparts. We sought to analyze our experience with mesh in addition to CS to determine its influence on hernia recurrence and surgical site occurrence (SSO).
Methods
A retrospective chart review of patients who underwent CS between 2013 and 2019 with or without biologic mesh reinforcement by a single surgeon was performed. Pre-operative data were identified and outcomes at one year were documented.
Results
97 patients were identified. Patients of all VHWG grades were studied, with the majority grade 2-3 (91.7%). Biologic mesh in the underlay position was used in 55 (56.7%) patients. The overall recurrence rate was 20.6% and the rate of abdominal bulge was 18.6%. The use of mesh was associated with a lower rate of hernia recurrence, but not abdominal bulge, SSO, or reoperation. VHWG grade and patient comorbidities were not associated with SSOs, recurrence, or reoperation.
Conclusion
The addition of biologic mesh in CS decreased hernia recurrence rates, and did not increase complication rates. Development of an SSO does not predict recurrence. The majority of the cohort consisted of VHWG Grade 2-3 patients, in whom inclusion of mesh reduced recurrence rates. As such, surgeons are advised to consider each patient's VHWG Grade in the context of existing literature when deciding whether to incorporate biologic mesh, rather than subscribe to habit.
