The impact of sarcopenia on oncologic abdominal wall reconstruction

2020 ◽  
Vol 122 (7) ◽  
pp. 1490-1497
Author(s):  
Chad M. Bailey ◽  
Mark V. Schaverien ◽  
Patrick B. Garvey ◽  
Jessie Liu ◽  
Charles E. Butler ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
The Impact

The impact of mesh reinforcement with components separation for abdominal wall reconstruction

2015 ◽  
Vol 221 (4) ◽  
pp. e123
Author(s):  
Seyed Amirhossein Razavi ◽  
Karan A. Desai ◽  
Peter W. Thompson ◽  
Alexandra M. Hart ◽  
Albert Losken
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Components Separation ◽  
Mesh Reinforcement ◽  
The Impact

The Impact of Mesh Reinforcement with Components Separation for Abdominal Wall Reconstruction

2018 ◽  
Vol 84 (6) ◽  
pp. 959-962 ◽  
Author(s):  
Seyed Amirhossein Razavi ◽  
Karan A. Desai ◽  
Alexandra M. Hart ◽  
Peter W. Thompson ◽  
Albert Losken
Keyword(s):  
Postoperative Complications ◽  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Recurrence Rate ◽  
Abdominal Wall Reconstruction ◽  
Abdominal Hernia ◽  
Fascial Closure ◽  
Site Infection ◽  
Components Separation ◽  
The Impact

The goal in abdominal wall reconstruction (AWR) is to minimize morbidity and prevent hernia recurrence. Components separation and mesh reconstruction are two options, however, with advantages and disadvantages. The purpose of this review was to investigate outcomes in patients with abdominal wall hernia undergoing primary closure with component separation (CS) versus CS with acellular dermal matrix (ADM) reinforcement (CS + mesh). Medical records of consecutive patients who underwent abdominal wall reconstruction using CS with or without ADM reinforcement were retrospectively reviewed. Primary fascial closure was achieved in all patients. ADM reinforcement when used was performed using the underlay technique. Reconstructive technique and postoperative complications including delayed healing, skin necrosis, fistula, seroma, hematoma and surgical site infection, recurrence, and reoperation were recorded. Comparisons between the two groups were assessed. One hundred and seven patients were included (mean age, 55.7; 51.4% male; median follow-up 297 days). Twenty-six patients (24%) underwent CS alone; whereas 81 patients (76%) CS + mesh placement. Patient comorbidities, including smoking (26%), diabetes (20%), and hypertension (46%); body mass index (mean 32.3 ± 7.6); and albumin level on the day of surgery (mean 3.4 ± 0.5 mg/dL) were not significantly different between groups. Surgical site infection was significantly higher among CS + mesh patients (22.2%) versus CS only patients (3.9%) (P = 0.02). The recurrence rate of abdominal hernia was significantly lower in CS + mesh patients compared with CS only (14.8% vs 34.6%; P = 0.02). No significant differences in other postoperative complications were identified between the two groups. ADM reinforcement at the time of components separation is often selected in more complex, higher risk patients. Although the incidence of infection was higher in these patients, it was usually treated without mesh removal and recurrence rate was significantly lower when compared to CS alone.

scholarly journals Abdominal Wall Reconstruction after Flap Surgery and the Effect on the Immune System

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
F. Popa ◽  
A. V. Georgescu
Keyword(s):  
Animal Models ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Control Group ◽  
Surgical Trauma ◽  
Abdominal Wall Defects ◽  
Flap Surgery ◽  
Proinflammatory Response ◽  
Flap Repairs ◽  
The Impact

Background. The aim of our study was to investigate the impact of abdominal wall reconstruction surgery on tissue anatomy and to explore how flap surgery influences the patient’s immune status. Methods. Experimental abdominal wall defects were created in 8 Sus scrofa (swine) animal models. The animals were divided into two groups: 4 swine were euthanized one month after surgery for the biopsies retrieval purpose and the other 4 swine were kept alive and the collection of blood samples has been done 6 months after surgery. In order to evaluate the relative gene expression in operated-on animal cohorts we compared them with samples from 4 healthy swine used as controls. Results. The inflammatory process was present in all types of repairs. Collagen I deposition was higher in the flap repairs. The expression level for the genes related to immune response after 6 months from surgery was relatively similar to the control group except minor alteration registered in the case of two swine models. Conclusion. Our findings indicate a less pronounced proinflammatory response to surgical trauma in animal models after flap surgery. The postoperative levels of the inflammatory cytokines did not show significant differences after abdominal wall reconstruction using flap surgery.

scholarly journals The Impact of Body Mass Index on Abdominal Wall Reconstruction Outcomes

2017 ◽  
Vol 139 (5) ◽  
pp. 1234-1244 ◽  
Author(s):  
Salvatore A. Giordano ◽  
Patrick B. Garvey ◽  
Donald P. Baumann ◽  
Jun Liu ◽  
Charles E. Butler
Keyword(s):  
Body Mass Index ◽  
Abdominal Wall ◽  
Body Mass ◽  
Abdominal Wall Reconstruction ◽  
The Impact

scholarly journals The Impact of Body Mass Index on Abdominal Wall Reconstruction Outcomes: A Comparative Study

2017 ◽  
Vol 225 (4) ◽  
pp. S167
Author(s):  
Salvatore Giordano ◽  
Patrick B. Garvey ◽  
Donald P. Baumann ◽  
Jun Liu ◽  
Charles E. Butler
Keyword(s):  
Body Mass Index ◽  
Comparative Study ◽  
Abdominal Wall ◽  
Body Mass ◽  
Abdominal Wall Reconstruction ◽  
The Impact

Authors’ response to: “Comment on the impact of sarcopenia on oncologic abdominal wall reconstruction”

2020 ◽  
Author(s):  
Alexander F. Mericli ◽  
Chad M. Bailey ◽  
Mark V. Schaverien ◽  
Patrick B. Garvey ◽  
Jessie Liu ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
The Impact

The impact of preoperative anxiety, depression, and chronic pain on outcomes in abdominal wall reconstruction

Hernia ◽  
2019 ◽  
Vol 23 (6) ◽  
pp. 1045-1051
Author(s):  
K. A. Schlosser ◽  
S. R. Maloney ◽  
T. Prasad ◽  
K. Kercher ◽  
B. T. Heniford ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Preoperative Anxiety ◽  
Anxiety Depression ◽  
The Impact

Abdominal Wall Reconstruction: The Uncertainty of the Impact of Drain Duration upon Outcomes

2016 ◽  
Vol 82 (3) ◽  
pp. 207-211 ◽  
Author(s):  
Margaret A. Plymale ◽  
Jennifer W. Harris ◽  
Daniel L. Davenport ◽  
Nicholas Smith ◽  
Salomon Levy ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Abdominal Wall ◽  
Body Mass ◽  
Abdominal Wall Reconstruction ◽  
Deep Infection ◽  
Wound Complications ◽  
Superficial Infection ◽  
Drain Removal ◽  
Grade One ◽  
The Impact

Drains are commonly used after abdominal wall reconstruction (AWR) to prevent seroma formation. Drain management is subjective, and the merits and drawbacks of drains are not well understood. After receiving Institutional Review Board approval, we queried our prospectively maintained surgical database for AWR cases from 2009 to 2012 to ascertain if the number of days postoperatively that drains are left in place impacts the incidence of surgical site complications. Number of drains, drain duration, wound complications, and interval to development of complications were recorded. Wound complications were defined as superficial cellulitis, seroma, hematoma, superficial infection, and deep infection. Among 117 AWRs, we investigated the 64 cases with Centers for Disease Control grade one wound classification. Longest drain duration varied widely (2–171 days postoperatively; mean = 22 days). Cases were divided into four groups based on duration prior to removal of all drains: ≤ 7 days (n = 18), 8 to 14 days (n = 16), 15 to 28 days (n = 18), or ≥29 days (n = 12). No significant relationship was found between incidence of seroma/hematoma and days postoperatively of last drain removal. Wound complications increased linearly with drain time. Using logistic regression to adjust for obesity (body mass index >35kg/m2), drain duration >2 weeks and operative time >220 minutes, only body mass index >35 remained an independent predictor of wound occurrence, P < 0.05. Wound complications occur frequently after AWR. Wound infections occur more commonly among patients with drains in place for more than 2 weeks. Strategies to reduce drain duration require furthermore investigation.

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