Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complications

Ventral hernia: Patient selection, treatment, and management

“…9 Obesity has also been identified as an independent risk factor for complications following ventral hernia repair, increasing the risk of surgical site infection (OR 1.06 per kg/m 2 , 95% CI 1.03-1.10), reoperation (OR 1.034 per kg/m 2 , 95% CI 1.00-1.08), and hernia recurrence (OR 1.07 per kg/m 2 , 95% CI 1.03-1.11). 10 In addition to obesity, an aging population with associated comorbidities, an increasingly sedentary community, and the persistence of smoking in society contribute to the high complication rates of ventral hernia repair.…”

“…10 High-risk patients are more likely to develop and acquire a ventral hernia. If non-operative management is pursued in these patients, the risk of incarceration and requiring emergency surgery is increased at an estimated 2-3%/year (Table 1).…”

Innovative Modifications for Preventing Mesh Infections

“…Body mass index >25 kg/m 2 , presence of deep space and organ infection, longer operative times, heavily contaminated wounds, bariatric surgery, dependent functional status of the patient, chronic obstructive pulmonary disease, advanced age, higher ASA grades are predictors of early development of incisional hernia after midline laparotomy [3][4][5][6][7][8][9]. Moreover, previous ventral hernia repair creates a vicious cycle of recurring ventral hernia repairs and decreases the success rate of surgical repair drastically after each failed repair [10].…”

Ventral and incisional hernia: the cost of comorbidities and complications

“…as [19][20][21][22][23][24][25] % for open repairs [7,8]. Other reasons for unplanned 30-day readmission following VIHR are ileus or obstruction, bleeding, pulmonary issues, and venous thromboembolism (VTE) [1].…”

“…Other reasons for unplanned 30-day readmission following VIHR are ileus or obstruction, bleeding, pulmonary issues, and venous thromboembolism (VTE) [1]. Further complicating the postoperative outcomes of VIHR, SSI has been demonstrated to increase a recurrence [7], which in the long-term also contributes to increased health care costs.…”