The Effect of BMI on Outcomes Following Complex Abdominal Wall Reconstructions

Desai, Karan; Razavi, Seyed Amirhossein; Hart, Alexandra M.; Thompson, Peter; Losken, Albert

doi:10.1097/sap.0000000000000673

Cited by 53 publications

(19 citation statements)

References 13 publications

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“…Abdominal wall reconstruction surgeries continue to be challenging, and complication and recurrence rates range from 20% to 63% 2,13 . The number of patients with complications found in our series (4, 22.2%) was similar to that found in previous studies (Figures 9 and 10).…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the abdominal wall: a case series

Kawamura¹,

Luna²,

Anlicoara³

et al. 2018

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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Patients with abdominal wall defects present challenging complications that require the use of advanced surgical approaches. Methods: This primary, retrospective, and descriptive study evaluated patients who underwent abdominal wall reconstruction at the Plastic Surgery Service of the Clinics Hospital of the Federal University of Pernambuco. Results: The medical records of 18 patients were reviewed, including 15 women (83.3%) and 3 men (16.7%), with a mean age of 41 years (range, 16-79 years). Seventeen patients (94.4%) had a history of previous surgery. The causes of abdominal injury were cesarean section in eight cases (44.4%), oncologic surgery in six (33.3%), trauma surgery in two (11.1%), and bariatric surgery in two (11.1%). The etiology of the defect was necrotizing fasciitis in eight cases (44.4%), incisional hernia in four (22.2%), trauma in two (11.1%), surgical wound dehiscence in two (11.1%), abdominal wall neoplasia in two (11.1%), and total thickness defect in one (5.5%). The surgical interventions included the component separation technique in seven cases (38.9%), simple VY advancement flap in six (33.3%), closure with abdominoplasty in three (16.7%), and tissue expander in two (11.1%). Four patients (22.2%) presented complications. Conclusions: Abdominal wall defects are challenging cases for plastic surgeons, as their treatment is difficult, but the results are satisfactory even in the most severe cases.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of the abdominal wall: a case series

Kawamura¹,

Luna²,

Anlicoara³

et al. 2018

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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“…A study published in 2016 reviewed 313 patients who underwent complex hernia repair analyzed the effect of obesity over a 15.6 month follow-up. They divided the population based on BMI according the World Health Organization (WHO) classification and found a significantly higher risk of hernia recurrence and reoperation in patients with increasing BMI [61]. Contrary to this, a more recent larger study from the MD Anderson group including 511 patients with a longer mean follow-up of 32 months demonstrated that class 1 or higher obesity does not affect hernia recurrence rates.…”

Section: Preoperative Optimizationmentioning

confidence: 94%

Refinements and Advancements in Anterior Component Separation

Kapur¹,

Butler²

2019

Hernia Surgery [Working Title]

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This chapter will explore the newest innovations for performing anterior component separation (CS). It will include open CS, perforator sparing CS and minimally invasive component separation (MICS). It will also address the use of various meshes and their plane of inset. It will cover soft tissue management including panniculectomy, quilting sutures and drains. Fascial closure techniques will also be included. The highlight of this chapter will be the description of tips and tricks of performing MICS. We will also touch upon preoperative preparation such as body mass index (BMI) optimization and smoking cessation as well as management of postoperative complications including surgical site infections, skin necrosis and seroma.

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“…The reduction of postoperative incisional hernias and wound complications with laparoscopic gastric bypass motivated development of the technique [17] . However, the risk of hernia recurrence has been shown to positively correlate with increased body mass index (BMI) regardless of the type of repair performed [18][19][20] . While excess weight must be addressed with patients desiring hernia repair, it is not feasible to expect all hernia patients to achieve ideal weight prior to an operation.…”

Section: Obesitymentioning

confidence: 99%

Abdominal wall procedures: the benefits of prehabilitation

Knapp¹,

Jedrzejewski²,

Martindale³

2020

PAR

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Prehabilitation for abdominal wall procedures provides an opportunity to further modify patient risk factors for surgical complications. It includes interventions that optimize nutrition, glycemic control, functional status, and utilization of the patient's microbiome pre-, intra-, and postoperatively. Through a multidisciplinary and anticipatory approach to patients' existing co-morbidities, the physiological stress of surgery may be attenuated to ultimately minimize perioperative morbidity in the elective setting. With increasing data to support the efficacy of prehabilitation in optimizing surgical outcomes and decreasing hospital length of stay, it is incumbent on the surgeon to employ these practices in elective abdominal wall reconstruction. Further research on the effects of prehabilitation interventions will help to shape and inform protocols that may be implemented beyond abdominal wall procedures in an effort to continually improve best practices in surgical care.

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The Effect of BMI on Outcomes Following Complex Abdominal Wall Reconstructions

Cited by 53 publications

References 13 publications

Reconstruction of the abdominal wall: a case series

Reconstruction of the abdominal wall: a case series

Refinements and Advancements in Anterior Component Separation

Abdominal wall procedures: the benefits of prehabilitation

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