Risk factors associated with early failure in complex abdominal wall reconstruction: A 5 year single surgeon experience

Abstract

Complex abdominal wall reconstruction (AWR) is commonly performed, but with a significant rate of surgical complications and hernia recurrence. The aim of this experiential review is to assess risk factors for hernia recurrence after complex AWR. A retrospective review of AWR patients from 2007–2012 was performed. Rates of hernia recurrence were assessed. Univariate analyses and subsequent multivariate logistic regression analysis was used to assess independent predictors of early hernia recurrence. One hundred and thirty-four consecutive cases of AWR were performed over a 5-year period. Hernia recurrence developed in 14 (10.4%) patients. Hernias derived from trauma (OR = 19.76, p = 0.011) and those who experienced postoperative wound infections (OR = 18.81, p = 0.004) were at increased risk for hernia recurrence. In conclusion, increased vigilance must be paid to patients presenting after trauma with massive loss of domain and those who experience postoperative infection, as these cohorts are at added risk for failed reconstruction.

Key Words:

• Component separation
• ventral hernia repair
• hernia recurrence
• abdominal wall reconstruction

Acknowledgements

We would like to acknowledge and thank Nancy Folsom, BSN for her assistance in the organisation and preparation of the IRB for this study. No external or internal funding was used for this current study.

Declaration of interest

The authors report no conflicts of interest. The authors alone re responsible for the content and writing of the paper.