Designing a ventral hernia staging system

Hernia : the Journal of Hernias and Abdominal Wall Surgery
C C PetroM J Rosen

Abstract

The absence of a standardized classification scheme for ventral hernias hinders comparisons within the literature, indirectly delaying meaningful discussions regarding technique. We aimed to generate a comprehensive staging system that stratifies patients by risk of developing wound morbidity and hernia recurrence. Our prospective database of all ventral hernia repairs (2006-2013) was reviewed with no exclusion based on technique or prosthetic. The presence of patient comorbidities, contamination and hernia dimensions-width/location on computed topography-was evaluated to identify variables most closely associated with surgical site occurrence (SSO) and recurrence. Predicted odds ratios and relative hazards, for SSO and recurrence, respectively, were used to partition patients into stages corresponding with increasing levels of risk. Hernia width (OR 2.24, HR 1.73) and the presence of contamination (OR 1.81, HR 2.04) were most significantly associated with increased risk of SSO and recurrence, while hernia location and the presence of comorbidities were not. Stage I hernias are <10 cm/clean and associated with low SSO and recurrence risk. Stage II hernias are 10-20 cm/clean or <10 cm contaminated and carry an intermediate risk ...Continue Reading

References

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Oct 24, 2013·Hernia : the Journal of Hernias and Abdominal Wall Surgery·N J SlaterH van Goor

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Citations

Jun 12, 2016·Surgical Endoscopy·Margaret A PlymaleJ Scott Roth
Nov 9, 2016·Journal of the American College of Surgeons·David M KrpataMichael J Rosen
Jun 21, 2017·Hernia : the Journal of Hernias and Abdominal Wall Surgery·I N HaskinsM J Rosen
Feb 13, 2018·Hernia : the Journal of Hernias and Abdominal Wall Surgery·I N HaskinsM J Rosen
Dec 19, 2019·World Journal of Surgery·Samuel G ParkerAlastair C J Windsor
May 2, 2017·Plastic and Reconstructive Surgery. Global Open·Jennifer E FligorGregory A Dumanian
Aug 24, 2018·Plastic and Reconstructive Surgery·Clayton C Petro, Michael J Rosen
Mar 10, 2017·Journal of Plastic Surgery and Hand Surgery·Jason M WeisslerJohn P Fischer
Aug 24, 2018·Plastic and Reconstructive Surgery·Clayton C Petro, Michael J Rosen
Dec 13, 2018·Hernia : the Journal of Hernias and Abdominal Wall Surgery·J A WegdamT S de Vries Reilingh
Nov 18, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·L van SilfhoutUNKNOWN Ventral Hernia Group Tilburg
May 15, 2018·The Surgical Clinics of North America·Michael J Rosen
Jun 8, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·J J M ClaessenM A Boermeester

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