TY  - CHAP
M1  - Book, Section
TI  - REPAIR OF VENTRAL HERNIA, OPEN COMPONENT PARTS SEPARATION
A1  - Ellison, E. Christopher
A1  - Zollinger, Robert M.
Y1  - 2016
N1  - 
T2  - Zollinger's Atlas of Surgical Operations, 10e
AB  - Ventral  hernias  in  the  anterior  abdominal  wall  include  both  spontaneous  or  primary  hernias  (e.g.,  umbilical,  epigastric,  and  spigelian)  and,  most  commonly,  incisional  hernias  that  occur  after  an  abdominal  operation.  It  is  estimated  that  2%  to  13%  of  all  abdominal  operations  result  in  an  incisional  hernia.  Risk  factors  for  the  development  of  an  incisional  hernia  include  obesity,  multiple  abdominal  procedures,  diabetes,  wound  infections,  and  the  use  of  immunosuppressive  medication(s).  Small  primary  ventral  hernias  are  often  successfully  closed  with  primary  tissue  repairs.  Repair  of  incisional  hernias  often  utilizes  synthetic  or  biologic  mesh  to  decrease  recurrence  rates.  In  some  patients,  the  use  of  mesh  is  contraindicated  or  not  desired  and  the  hernia  defect  is  too  large  or  extensive  to  allow  for  appropriate  primary  closure.  In  the  event  of  real  or  potential  contamination,  the  use  of  synthetic  mesh  may  be  contraindicated.  In  addition,  patients  may  request  or  require  a  more  cosmetic  repair  of  their  abdominal  wall  as  part  of  their  treatment  with  “medialization”  of  their  abdominal  wall  musculature  that  was  previously  displaced  due  to  the  ventral/incisional  hernia.  In  patients  whom  synthetic  mesh  cannot  be  utilized,  native  abdominal  wall  fascia  and  musculature  must  be  used  to  close  the  hernia  defect  and  reapproximate  the  abdominal  wall  components  while  minimizing  the  potential  for  hernia  recurrence.  Open  component  separation  is  used  almost  exclusively  for  midline  ventral  hernia  defects,  whether  they  are  single  or  multiple,  when  the  use  of  synthetic  or  biologic  mesh  is  not  an  option  for  repair.  Component  separation  enables  the  detection  and  repair  of  multiple  defects—a  common  finding  in  midline  incisional  hernias.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1127274032
ER  -