ArticleSurgery2020
Surgical site occurrences, not body mass index, increase the long-term risk of ventral hernia recurrence.
Article in Surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of smoking on ventral and inguinal hernia repair: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Pooled it
- Umbilical hernia repair and recurrence: need for a clinical trial?BMC surgery · 2021Pooled it
- Comparative Outcomes of Two Non-Crosslinked Porcine Acellular Dermal Matrices in Complex Abdominal Wall Reconstruction: A Randomized Controlled Trial and an Observational Cohort Study.World journal of surgery · 2026Trial
- Onlay mesh versus suture repair for smaller umbilical hernias in adults-early results from SUMMER trial: randomized clinical trial.BJS open · 2024Trial
- Short-term complications after onlay versus preperitoneal mesh repair of umbilical hernias: a prospective randomized double-blind trial.Langenbeck's archives of surgery · 2023Trial
- Biologic vs Synthetic Mesh for Single-stage Repair of Contaminated Ventral Hernias: A Randomized Clinical Trial.JAMA surgery · 2022Trial
- Lifestyle-related risk factors and recurrence after ventral hernia surgery: nationwide registry and survey study.BJS open · 2026Article
- Abdominal wall reconstruction in ventral hernia repair: do current models predict surgical site risk?Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Risk factors and outcomes for early returns to the operating room following abdominal wall hernia repairs.Surgery in practice and science · 2025Article
- Determining a BMI threshold for ventral hernia recurrence among a predominantly underrepresented minority population.Hernia : the journal of hernias and abdominal wall surgery · 2025Observational
- Article
- Review
- The current role of barbed sutures in fascial closure of ventral hernia repair: a multicenter study using the abdominal core health quality collaborative database.Surgical endoscopy · 2024Article
- Transversus abdominis release with biosynthetic mesh for large ventral hernia repair: a 5-year analysis of clinical outcomes and quality of life.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Ten-year outcomes following ventral hernia repair: making the case for better post-market surveillance in the USA.Surgical endoscopy · 2023Article
- Body Mass Index Within Multifactor Predictors of Ventral Hernia Recurrence: A Retrospective Cohort Study.Cureus · 2023Article
- Long-term reoperation rate following primary ventral hernia repair: a register-based study.Hernia : the journal of hernias and abdominal wall surgery · 2022Article
- Delayed primary closure (DPC) of the skin and subcutaneous tissues following complex, contaminated abdominal wall reconstruction (AWR): a propensity-matched study.Surgical endoscopy · 2022Article
- Technique of Abdominal Wall Tissue Expansion for the Treatment of Massive Complicated Ventral Hernias.Plastic and reconstructive surgery. Global open · 2022Article
- The European Hernia Society Prehabilitation Project: A Systematic Review of Intra-Operative Prevention Strategies for Surgical Site Occurrences in Ventral Hernia Surgery.Frontiers in surgery · 2022Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundRecurrence rates after ventral hernia repair vary widely and evidence about risk factors for recurrence are conflicting. There is little evidence for risk factors for long-term recurrence.
methodsPatients who underwent ventral hernia repair at our institution and were captured in the American College of Surgeons-National Surgical Quality Improvement Program database between 2002 and 2015 were included. We reviewed all demographic, procedural, and hernia-specific data.
resultsSix hundred and thirty patients were included for analysis with a median follow-up of 4.9 years (inter-quartile range, 2-7.3 years). By univariate analysis, index hernia repairs were more likely to recur if defect size was ≥4 cm (P = .019), no mesh was used (P = .026), or if the repair was for a recurrent hernia (P = .001). Five-year cumulative incidence of recurrence and reoperation was 24.3% and 16.0%, respectively. Patients with a perioperative surgical site occurrence, which included superficial, deep-incisional, and organ space surgical site infections as well as wound disruption, had a 5-year cumulative incidence of recurrence of 54.9% compared with 22.6% for those without surgical site occurrence. By multivariable analysis, non-primary hernia repair (hazard ratio 1.7, 95% confidence interval 1.2-2.4, P = .005) and any postoperative surgical site occurrence (hazard ratio 1.9, 95% confidence interval 1.1-3.6, P = .02) were the only risk factors predictive of recurrence. Patient body mass index had no independent effect on recurrence.
conclusion1 in 4 patients undergoing an open ventral hernia repair will have a recurrence after 5 years, and this risk is doubled among patients who experience any perioperative surgical site occurrence. After controlling for patient comorbidities, including body mass index, hernia size, and mesh position, the most significant risk factor for recurrence after ventral hernia repair was a non-primary hernia and surgical site occurrence.
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