Source: Colorectal Disease; Oct 2017; vol. 19 ; p. 57
Publication Date: Oct 2017
Publication Type(s): Conference Abstract
Available at Colorectal Disease - from Wiley Online Library Medicine and Nursing Collection 2018 - NHS
Abstract:Background: Abdominal closure with loss of tissue domain in the presence of enterocutaneous fistula, stoma or infection can be challenging. Increasing incidence of these herniae necessitates development of specialist units. We assessed the outcomes of components separation and complex abdominal wall reconstructions as a newly designed service in our unit. Methods: Data from prospectively held database was analysed from 2015 onwards when the service was set up. Patients were classified by the Ventral Hernia Working Group (VHWG) grading system. Primary endpoints were outcomes, reconstruction technique, length of stay in hospital, complications and recurrence. Secondary endpoints were service need and financial viability. Results: Ten reconstructive repairs (4 males, 6 females) were undertaken over the last year. Median age was 62 years and length of stay was 7 days. Median follow-up was 5 months (range 1-12 months). There were 9 grade III hernias and 1 grade IV hernia. All patients underwent component separation with sub and/or on-lay, synthetic mesh reinforcement (n = 2) or cross-linked porcine dermis reinforcement (n = 8). Wound infection was seen in 1 case, seroma formation in 2 cases. No early recurrence or return to theatre was demonstrable in our cohort. All patients were surveyed post procedure and rating of their outcomes was good/excellent. Conclusions: Components separation and reinforcement with biological mesh for grade III and IV hernias in our unit can be undertaken with outcomes comparable to high volume centres. Whilst service setup bears significant financial implications, patient satisfaction and outcomes of treatment in their local Trust are of paramount importance.