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

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

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.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Wall / surgery
  • Abdominoplasty / methods*
  • Acellular Dermis*
  • Elective Surgical Procedures / methods*
  • Female
  • Follow-Up Studies
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / trends*
  • Propensity Score
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh*
  • Time Factors
  • Treatment Outcome