Risk factors for wound morbidity after open retromuscular (sublay) hernia repair

摘要: Background Retrorectus repairs (RR) of abdominal wall hernias are growing in popularity, yet wound morbidity and predictors this context have been characterized poorly. Models aimed at predicting typically do not control for technique and/or location mesh. Our aim was to describe risk factors specifically the RR hernia repair. hypothesis that incidence with mesh sublay would be less than predicted by a model does position. Methods Consecutive least 90-day follow-up were identified our prospective database analyzed. The primary outcome measures surgical-site occurrence (SSO) infection (SSI) via modern, standardized definitions. For SSO, statistical analysis performed univariate analysis, χ 2 , logistic regression as well multivariate regression. Results A total 306 patients met inclusion criteria. Eighty-four SSOs 72 (23.5%) included 48 (15.7%) SSIs, 14 (4.6%) instances cellulitis, 12 (3.9%) skin dehiscences, 6 (2.0%) seromas, 4 (1.3%) hematomas but no excision or fistula formation. Treatment entailed antibiotics alone 30 patients, bedside drainage procedures, 9 radiographically assisted 10 returns operating room debridement. After diabetes (OR 2.41), width >20 cm 2.49), use biologic 2.93) statistically associated development SSO ( P  = .11). SSI rates anticipated recent prediction 50–80% 17–83%, respectively, compared actual 20–46% 7–32%. Conclusion Based on large cohort we contributing repairs. Paradoxically, an independent predictor morbidity. clinically important complications predictive models suggest retromuscular (sublay) position may more advantageous.