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Abdominal Wall Reconstruction

Abdominal Wall Reconstruction ORIGINAL ARTICLE Lessons Learned From 200 “Components Separation” Procedures Jason H. Ko, MD; Edward C. Wang, PhD; David M. Salvay, MS; Benjamin C. Paul, BA; Gregory A. Dumanian, MD Objectives: To determine the efficacy and describe the Results: Primary components separation (n = 158) yielded evolution of the “components separation” technique for a 22.8% recurrence rate. Closure of the midline tissues with augmentation of the repair using an acellular cadaveric der- abdominal wall repair in 200 consecutive patients. mis underlay (n = 18) had a 33.3% recurrence rate requir- ing a second operation, whereas intra-abdominal soft poly- Design: Retrospective medical record review. propylene mesh (n = 18) had 0% recurrence (P = .04). Elevated body mass index was a significant risk factor pre- Setting: Northwestern Memorial Hospital, Chicago, dicting hernia recurrence (P = .003). Contamination (P = .04) Illinois. and enterocutaneous fistula (P = .02) at the time of surgery were associated with increased major complications, whereas Patients: Two hundred consecutive patients who un- body mass index (P = .01) and diabetes mellitus (P = .04) derwent ventral hernia repair using the components sepa- were associated with increased minor complications. ration technique. Conclusions: Large complex hernias can be reliably http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Abdominal Wall Reconstruction

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References (42)

Publisher
American Medical Association
Copyright
Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/archsurg.2009.192
pmid
19917942
Publisher site
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Abstract

ORIGINAL ARTICLE Lessons Learned From 200 “Components Separation” Procedures Jason H. Ko, MD; Edward C. Wang, PhD; David M. Salvay, MS; Benjamin C. Paul, BA; Gregory A. Dumanian, MD Objectives: To determine the efficacy and describe the Results: Primary components separation (n = 158) yielded evolution of the “components separation” technique for a 22.8% recurrence rate. Closure of the midline tissues with augmentation of the repair using an acellular cadaveric der- abdominal wall repair in 200 consecutive patients. mis underlay (n = 18) had a 33.3% recurrence rate requir- ing a second operation, whereas intra-abdominal soft poly- Design: Retrospective medical record review. propylene mesh (n = 18) had 0% recurrence (P = .04). Elevated body mass index was a significant risk factor pre- Setting: Northwestern Memorial Hospital, Chicago, dicting hernia recurrence (P = .003). Contamination (P = .04) Illinois. and enterocutaneous fistula (P = .02) at the time of surgery were associated with increased major complications, whereas Patients: Two hundred consecutive patients who un- body mass index (P = .01) and diabetes mellitus (P = .04) derwent ventral hernia repair using the components sepa- were associated with increased minor complications. ration technique. Conclusions: Large complex hernias can be reliably

Journal

JAMA Surgery – American Medical Association

Published: Nov 1, 2009

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