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Am J Surg. 2018 Jul;216(1):60-66. doi: 10.1016/j.amjsurg.2018.01.072. Epub 2018 Feb 5.

Hospital readmission following open, single-stage, elective abdominal wall reconstructions using acellular dermal matrix affects long-term hernia recurrence rate.

Author information

1
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
2
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: cbutler@mdanderson.org.

Abstract

BACKGROUND:

We evaluated the incidence of and the risk factors for readmission in patients who underwent abdominal wall reconstruction (AWR) using acellular dermal matrix (ADM) and assess whether readmission affects AWR long-term outcomes.

METHODS:

A retrospective, single-center study of patients underwent AWR with ADM was conducted. The primary outcome was the incidence of unplanned readmission within 30 days after the initial discharge post-AWR. Secondary outcomes were surgical site occurrence (SSO) and hernia recurrence at follow-up.

RESULTS:

Of 452 patients (mean age, 59 years; mean follow-up, 35 months), 29 (6.4%) were readmitted within 30 days. Most readmissions were due to SSO (44.8%) or wound infections (12.8%). The hernia recurrence rate was significantly higher in readmitted patients (17.2% vs 9.9%; P = 0.044). Wider defects, prolonged operative time, and coronary artery disease were independent predictors of readmission.

CONCLUSIONS:

Readmission is associated with hernia recurrence on long-term follow-up. SSO is the most common cause for readmission.

KEYWORDS:

Abdominal wall; Acellular dermis; Hernia; Postoperative complications; Readmission; Surgical mesh

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