Delayed vs single-staged abdominal wall reconstruction in contaminated ventral hernia

Area of Science:

• Surgical Innovation
• Hernia Repair Techniques
• Abdominal Wall Reconstruction

Background:

• Contaminated ventral hernia repairs present a surgical dilemma: single-stage repair or delayed reconstruction.
• Surgeons must weigh risks of immediate repair against potential benefits of a staged approach in contaminated fields.

Purpose of the Study:

• To compare wound complications, long-term hernia recurrence, and quality of life.
• To evaluate delayed versus single-staged abdominal wall reconstruction (AWR) in clean-contaminated and contaminated wounds.

Main Methods:

• Retrospective review of adult patients undergoing open AWR with retromuscular synthetic mesh (2014-2023).
• Comparison of delayed AWR (separate operation without mesh initially) versus single-staged AWR (mesh placed concurrently).
• Outcomes analyzed included wound morbidity, reoperation, and hernia recurrence rates.

Main Results:

• 63 delayed AWR and 375 single-staged AWR patients were analyzed with a median 3-year follow-up.
• Wound debridement and mesh excision rates were similar between groups (p > 0.05).
• No significant differences observed in wound morbidity, reoperation, or hernia recurrence (p > 0.05).

Conclusions:

• Both delayed and single-stage AWR are viable options for ventral hernias with clean-contaminated or contaminated wounds.
• Patient selection and surgical strategy can be tailored based on individual case complexity.
• Further research may explore long-term quality of life differences.