National Outcomes for Open XXXX Repair Techniques in Complex Abdominal Wall Reconstruction.

@entity1 @entity4037 @entity47194
Modern adjuncts to complex, open @entity4037 repair often include component separation (CS) and/or panniculectomy ( @entity47194 ). This study examines nationwide data to determine how these techniques impact postoperative complications. The National Surgical Quality Improvement Program database was queried from 2005 to 2013 for inpatient, elective open @entity4037 (OVHR). Cases were grouped by the need for and type of concomitant advancement flaps: OVHR alone (OVHRA), OVHR with CS, OVHR with panniculectomy ( @entity47194 ), or both @entity47194 (BOTH). Multivariate regression to control for confounding factors was conducted. There were 58,845 OVHR: 51,494 OVHRA, 5,357 CS, 1,617 @entity47194 , and 377 BOTH. Wound complications (OVHRA 8.2%, CS 12.8%, @entity47194 14.4%, BOTH 17.5%), general complications (15.2%, 24.9%, 25.2%, 31.6%), and major complications (6.9%, 11.4%, 7.2%, 13.5%) were different between groups (P < 0.0001). There was no difference in mortality. Multivariate regression showed CS had higher odds of wound [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.5-2.0], general (OR 1.5, 95% CI: 1.3-1.8), and major complications (OR 2.1, 95%, CI: 1.8-2.4), and longer length of stay by 2.3 days. @entity47194 had higher odds of wound (OR 1.5, 95%, CI: 1.3-1.8) and general complications (OR 1.7, 95%CI: 1.5-2.0). Both CS and @entity47194 had higher odds of wound (OR 2.2, 95%, CI: 1.5-3.2), general (OR 2.5, 95%, CI: 1.8-3.4), and major complications (OR 2.2, 95%CI: 1.4-3.4), and two days longer length of stay. In conclusion, @entity1 undergoing OVHR that require CS or @entity47194 have a higher independent risk of complications, which increases when the procedures are combined.
