![[ Visit Client Website ]](images/banner.gif)
Patients undergoing incisonal/ventral hernia repair are at risk of developing several postoperative complications particularly venous thromboembolism (VTE) which is a major cause of morbidity and mortality. (1-5) The aim of this study was to assess 30-day postoperative morbidity and mortality of patients undergoing incisional/ventral hernia repair and to determine the association between component separation and VTE.
Methods:
We reviewed the 2005-2011 ACS-NSQIP databases to identify patients undergoing incisional/ventral hernia repair. Preoperative variables and postoperative outcomes were compared between a component separation group and a non-component separation group. Chi-square tests and Fisher’s exact test were used for categorical variables and t-tests for continuous variables. Logistic regression analysis was performed to determine preoperative predictors for complications in both groups.
Results
34,541 patients were included in our study; 501 patients underwent a component separation procedure. A higher rate of wound complications, minor/major morbidity, mortality and return to the operating room (OR) occurred in the component separation group. However, there was no statistically significant difference in deep vein thrombosis/thrombophlebitis and pulmonary embolism rates between the two groups (p=0.780 and p=0.591, respectively). Several risk factors were significantly associated with postoperative complications in both groups.
Conclusions
Component separation is used for large and complex incisional/ventral hernia repairs to achieve tension-free midline closure. Although it is associated with higher incidence of wound complication, morbidity and mortality, perhaps due to the complexity of the defects, it does contribute to increased VTE rates. This may suggest it improves abdominal wall physiology thereby preventing VTE in these patients.