Sanjay Naran MD, Sameer Shakir BS, Patrick Emelife MD, Meghan Quigley MD, James Russavage DMD MD, Ernest Manders MD, J Peter Rubin MD, Carolyn De La Cruz MD, Michael Gimbel MD, Vu Nguyen MD Department of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh , PA
While components separation of the abdominal musculature is a technique that has been reviewed in the past, there are few large series studies, with true long-term follow-up, that are focused on understanding the individual perioperative factors that may increase the risk of complications. This study was undertaken to address this paucity, in an effort to characterize risk factors for morbidity following abdominal components separation in complicated patients. We set out to identify predictive factors that may allow surgeons to optimize preventative care and treatment strategies and better counsel patients preoperatively in regards to their true risk of morbidity.
A comprehensive retrospective review was performed for patients undergoing components separation between 2000 and 2010, with a minimum follow-up of 1 year (IRB# PRO10080565). Components separation was defined as midline, direct, fasciafascia apposition of the rectus abdominis muscles. Patients receiving synthetic or biologic mesh for underlay or overlay reinforcement were included in the study. Analyses were performed using StataSE 13.0 (College Station, Texas). Multivariable logistic regression analysis was utilized to calculate odds ratios (ORs) to predict adverse clinical outcomes as a function of various patient characteristics (i.e., pre-operative, peri-operative, and post-operative factors). Multivariable models were constructed using stepwise backward selection methods. A backward selection criterion for model fit of p2: 17.5%
BMI: 32.7 ± 7.7 kg/m2
Clean-‐Contaminated or Contaminated at Case Start:
Pa#ent Characteris#cs Respiratory Disease Prior Mesh Use Clean Contaminated Mesh Removal Gastrointes;nal Disease Any Complica;on
