Management of recurrent hernia after components separation: 10-year experience with abdominal wall reconstruction at an academic medical center

Charles S. Hultman, Winnie M Y Tong, Benjamin J. Kittinger, Bruce Cairns, D. Wayne Overby, Preston B. Rich

Research output: Contribution to journalArticle

Abstract

Purpose: Separation of the components has become the standard of care for abdominal wall reconstruction, especially in the setting of infected, previously infected, or contaminated wounds. Although the safety and efficacy of this technique have been established, less is known about long-term outcomes. This article focuses on the management of recurrent hernia after components separation for abdominal wall reconstruction. Methods: We performed a retrospective, institutional review board-approved study of components separation for abdominal wall reconstruction at an academic medical center, over a 10-year period. Results: Between 2000 and 2009, we performed components separation in 136 patients (mean follow-up, 4.4 years). Twenty-six patients (19.1%) developed recurrent hernia (mean age, 49.8 years; body mass index, 30.7; previous abdominal operations, 3.5; hernia size, 342 cm; length of stay, 9.1 days). Mean time to recurrence was 319 days. Of the 16/26 patients who underwent repair of recurrence, 15 had successful repair, leaving 11/136 patients (8.1%) with persistent hernia. Of the 26 recurrences, 22 (85%) occurred within the first half of the study. Repair of recurrent hernias was accomplished by placement of additional mesh in 14/15 patients. Conclusions: Recurrent hernia after components separation may be related to procedural learning curves and can be successfully treated through repeat repair, yielding high rates of successful abdominal wall reconstruction.

Original languageEnglish (US)
Pages (from-to)504-507
Number of pages4
JournalAnnals of plastic surgery
Volume66
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

Fingerprint

Abdominal Wall
Hernia
Recurrence
Learning Curve
Herniorrhaphy
Research Ethics Committees
Standard of Care
Length of Stay
Body Mass Index
Safety
Wounds and Injuries

Keywords

  • abdominal wall reconstruction
  • biologic mesh
  • components separation
  • Hernia repair

ASJC Scopus subject areas

  • Surgery

Cite this

Management of recurrent hernia after components separation : 10-year experience with abdominal wall reconstruction at an academic medical center. / Hultman, Charles S.; Tong, Winnie M Y; Kittinger, Benjamin J.; Cairns, Bruce; Overby, D. Wayne; Rich, Preston B.

In: Annals of plastic surgery, Vol. 66, No. 5, 01.05.2011, p. 504-507.

Research output: Contribution to journalArticle

Hultman, Charles S. ; Tong, Winnie M Y ; Kittinger, Benjamin J. ; Cairns, Bruce ; Overby, D. Wayne ; Rich, Preston B. / Management of recurrent hernia after components separation : 10-year experience with abdominal wall reconstruction at an academic medical center. In: Annals of plastic surgery. 2011 ; Vol. 66, No. 5. pp. 504-507.
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