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Complex abdominal wall hernias: a new classification system and approach to management based on review of 133 consecutive patients.

Publication ,  Journal Article
Hadeed, JG; Walsh, MD; Pappas, TN; Pestana, IA; Tyler, DS; Levinson, H; Mantyh, C; Jacobs, DO; Lagoo-Deenadalayan, SA; Erdmann, D
Published in: Ann Plast Surg
May 2011

BACKGROUND: Plastic surgeons are increasingly involved in the repair of complex ventral hernias. Although this typically involves recurrent incisional hernias, operative strategies can be applied to most abdominal wall defects, including chronic wounds with or without exposed mesh, enterocutaneous fistulas, or hernias associated with significant pannus formation. METHODS: This is a retrospective review of a single institution/single surgeon experience of complex ventral hernia repair performed over a 5-year period. Patients were classified into different hernia types based on their characteristics and underwent hernia repair according to the presented algorithm. RESULTS: A total of 133 patients underwent a complex ventral hernia repair between January 2005 and September 2009. The separation of components technique was used in the majority of cases. Permanent or biologic mesh was added in select patients. Adjunctive procedures were performed as indicated. The majority of short-term (less than 1 year) recurrences occurred in patients expected to have impaired wound healing due to comorbid conditions. In these patients, the recurrence rate was reduced when autologous repair was reinforced with mesh. CONCLUSION: Autologous tissue is the preferred method for reconstruction of complex ventral hernias. In certain instances, such as contamination, use of an acellular dermal matrix mesh is added as a temporizing measure. A subset of patients who will be prone to recurrence remains. Long-term follow-up is needed to confirm reliable and reproducible results.

Duke Scholars

Published In

Ann Plast Surg

DOI

EISSN

1536-3708

Publication Date

May 2011

Volume

66

Issue

5

Start / End Page

497 / 503

Location

United States

Related Subject Headings

  • Young Adult
  • Wound Healing
  • Treatment Outcome
  • Transplantation, Autologous
  • Surgical Mesh
  • Surgical Flaps
  • Surgery
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Hadeed, J. G., Walsh, M. D., Pappas, T. N., Pestana, I. A., Tyler, D. S., Levinson, H., … Erdmann, D. (2011). Complex abdominal wall hernias: a new classification system and approach to management based on review of 133 consecutive patients. Ann Plast Surg, 66(5), 497–503. https://doi.org/10.1097/SAP.0b013e3182145387
Hadeed, Josef G., Mark D. Walsh, Theodore N. Pappas, Ivo A. Pestana, Douglas S. Tyler, Howard Levinson, Christopher Mantyh, Danny O. Jacobs, Sandhya A. Lagoo-Deenadalayan, and Detlev Erdmann. “Complex abdominal wall hernias: a new classification system and approach to management based on review of 133 consecutive patients.Ann Plast Surg 66, no. 5 (May 2011): 497–503. https://doi.org/10.1097/SAP.0b013e3182145387.
Hadeed JG, Walsh MD, Pappas TN, Pestana IA, Tyler DS, Levinson H, et al. Complex abdominal wall hernias: a new classification system and approach to management based on review of 133 consecutive patients. Ann Plast Surg. 2011 May;66(5):497–503.
Hadeed, Josef G., et al. “Complex abdominal wall hernias: a new classification system and approach to management based on review of 133 consecutive patients.Ann Plast Surg, vol. 66, no. 5, May 2011, pp. 497–503. Pubmed, doi:10.1097/SAP.0b013e3182145387.
Hadeed JG, Walsh MD, Pappas TN, Pestana IA, Tyler DS, Levinson H, Mantyh C, Jacobs DO, Lagoo-Deenadalayan SA, Erdmann D. Complex abdominal wall hernias: a new classification system and approach to management based on review of 133 consecutive patients. Ann Plast Surg. 2011 May;66(5):497–503.

Published In

Ann Plast Surg

DOI

EISSN

1536-3708

Publication Date

May 2011

Volume

66

Issue

5

Start / End Page

497 / 503

Location

United States

Related Subject Headings

  • Young Adult
  • Wound Healing
  • Treatment Outcome
  • Transplantation, Autologous
  • Surgical Mesh
  • Surgical Flaps
  • Surgery
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies