J. Zakhary1,2, B. D. Denny1, A. Kilic1, J. I. De La Torre1,2 1University Of Alabama At Birmingham,Plastic Surgery,Birmingham, AL, USA 2Birmingham V.A. Medical Center,Plastic Surgery,Birmingham, AL, USA
Introduction: Abdominal wall reconstruction with mobilization of autologous tissue has continued to evolve as a safe and reliable option for patients with large ventral wall hernias.?
Methods: With the goal of evaluating how the application of components separation has evolved in our practice, morbidity and recurrence rates in patients who underwent reconstruction for incisional ventral hernia, were retrospectively reviewed. The charts of 284 patients treated by a single surgeon between 1999 and 2016 were reviewed and patients with a minimum of two-year follow-up were included. Two data groups, an early group (1999-2004) and a late group (2009-2014) were evaluated, each over a five-year period. Outcomes from the data collection period were compared and significant changes in technique were noted.
Results: In the early group, the recurrence rate was 13% and primary approximation of the fascial defect was achieved in 77% of the patients. Overall morbidity rate was 38%, with significant complications occurring in 17% of patients, wound healing problems occurring in 13% and seromas occurring in 3%. In the late group, the recurrence rate was 7% and and primary approximation of the fascial defect was achieved in 92% of the patients. Overall morbidity was 46%, with significant complications occurring in 17% wound healing problems occurring in 14% and seromas occurring in 17%.
Conclusions: In patients with incisional hernias, techniques involving autologous tissue mobilization are safe and associated with low recurrence rates. Refinements in techniques have led to decreased recurrence rate.