Early versus delayed complex abdominal wall reconstruction with biologic mesh following damage-control surgery
Shekhar Gogna1, Rifat Latifi, James Choi
1From the Department of Surgery, Westchester Medical Center and New York Medical College (S.G., R.L., J.C., J.C., K.P., P.L.A., A.J.P., J.K., D.J.S., A.S., P.R.).
The Journal of Trauma and Acute Care Surgery
|January 28, 2021
Summary
Early complex abdominal wall reconstruction (e-CAWR) in acute settings is associated with a shorter hospital stay compared to delayed reconstruction. This finding is crucial for optimizing patient recovery after damage-control surgery.
Area of Science:
- Abdominal Wall Reconstruction
- Surgical Outcomes
- Trauma Surgery
Background:
- Damage-control surgery for trauma and intra-abdominal catastrophe often leads to significant morbidities and complications.
- Complex abdominal wall reconstruction (CAWR) is a critical procedure for managing these challenging cases.
Purpose of the Study:
- To compare the outcomes of early complex abdominal wall reconstruction (e-CAWR) versus delayed complex abdominal wall reconstruction (d-CAWR) in acute settings.
- To identify factors influencing hospital length of stay after CAWR.
Main Methods:
- Pooled analysis of retrospective and prospective data from 2013-2019.
- Comparison of demographic, intraoperative, and postoperative variables between e-CAWR and d-CAWR groups.
- Multivariable linear regression to assess predictors of hospital length of stay.
Main Results:
- The e-CAWR group had higher ASA and VHWG grades, indicating greater patient acuity.
- Postoperative complications, reoperations, and mortality were similar between early and delayed reconstruction groups.
- Early CAWR was independently associated with a significantly shorter hospital length of stay.
Conclusions:
- Early complex abdominal wall reconstruction in acute settings is a safe and effective option.
- Performing CAWR earlier may lead to reduced hospital length of stay without increasing postoperative complications.
