Abstract
Background: Patients undergoing incisional/ventral hernia repair are at risk of developing several postoperative complications particularly venous thromboembolism (VTE), which is a major cause of morbidity and mortality. 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 American College of Surgeons National Surgical Quality Improvement Program 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. The.2 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: Thirty-four thousand five hundred forty-one 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 occurred in the component separation group. However, there was no statistically significant difference in deep vein thrombosis/thrombophlebitis and pulmonary embolism rates between the 2 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 component separation hernia repair is associated with -higher incidence of wound complication, morbidity, and mortality, perhaps because of the complexity of the defects, it does not seem to be - associated with increased VTE rates.