Evidence-based strategies for the prehabilitation of the abdominal wall reconstruction patient

Nichole A. Joslyn, Nick O. Esmonde, Robert Martindale, Juliana Hansen, Ibrahim Khansa, Jeffrey E. Janis

Research output: Contribution to journalArticle

Abstract

It is inherently challenging to achieve successful surgical outcomes for ventral hernia repairs. For complex ventral hernias, attempts to reconstruct the abdomen in patients who are overweight, deconditioned, malnourished, chronically infected or inflamed, have previous hernia recurrence, or otherwise carry a number of serious comorbidities affecting their surgical fitness are a major undertaking requiring careful preparation and planning. As the rate of abdominal wall reconstructions rises, so does the complexity of these procedures. One could argue that the prehabilitation of these patients is equally, if not more, important than the surgical technique itself. To achieve desirable outcomes and avoid surgical-site occurrences (SSOs), the surgeon must familiarize him/herself with ways to optimize a patient preoperatively. Understanding and identifying the aforementioned modifiable risk factors for SSOs is crucial. It is also important to recognize the impact that acute changes in the microbiome perioperatively can have on the postoperative success. Familiarizing oneself with the available literature for these patients is imperative. This review presents discussion and guidance for understanding the challenges and best practices for providing hernia surgery and abdominal wall reconstruction and achieving durable outcomes, with minimal SSOs.

Original languageEnglish (US)
Pages (from-to)21S-29S
JournalPlastic and reconstructive surgery
Volume142
Issue number3S
DOIs
StatePublished - Sep 1 2018

Fingerprint

Abdominal Wall
Ventral Hernia
Hernia
Herniorrhaphy
Microbiota
Practice Guidelines
Abdomen
Comorbidity
Recurrence

ASJC Scopus subject areas

  • Surgery

Cite this

Evidence-based strategies for the prehabilitation of the abdominal wall reconstruction patient. / Joslyn, Nichole A.; Esmonde, Nick O.; Martindale, Robert; Hansen, Juliana; Khansa, Ibrahim; Janis, Jeffrey E.

In: Plastic and reconstructive surgery, Vol. 142, No. 3S, 01.09.2018, p. 21S-29S.

Research output: Contribution to journalArticle

Joslyn, Nichole A. ; Esmonde, Nick O. ; Martindale, Robert ; Hansen, Juliana ; Khansa, Ibrahim ; Janis, Jeffrey E. / Evidence-based strategies for the prehabilitation of the abdominal wall reconstruction patient. In: Plastic and reconstructive surgery. 2018 ; Vol. 142, No. 3S. pp. 21S-29S.
@article{043f60a864fd495795f8d8046f9780a0,
title = "Evidence-based strategies for the prehabilitation of the abdominal wall reconstruction patient",
abstract = "It is inherently challenging to achieve successful surgical outcomes for ventral hernia repairs. For complex ventral hernias, attempts to reconstruct the abdomen in patients who are overweight, deconditioned, malnourished, chronically infected or inflamed, have previous hernia recurrence, or otherwise carry a number of serious comorbidities affecting their surgical fitness are a major undertaking requiring careful preparation and planning. As the rate of abdominal wall reconstructions rises, so does the complexity of these procedures. One could argue that the prehabilitation of these patients is equally, if not more, important than the surgical technique itself. To achieve desirable outcomes and avoid surgical-site occurrences (SSOs), the surgeon must familiarize him/herself with ways to optimize a patient preoperatively. Understanding and identifying the aforementioned modifiable risk factors for SSOs is crucial. It is also important to recognize the impact that acute changes in the microbiome perioperatively can have on the postoperative success. Familiarizing oneself with the available literature for these patients is imperative. This review presents discussion and guidance for understanding the challenges and best practices for providing hernia surgery and abdominal wall reconstruction and achieving durable outcomes, with minimal SSOs.",
author = "Joslyn, {Nichole A.} and Esmonde, {Nick O.} and Robert Martindale and Juliana Hansen and Ibrahim Khansa and Janis, {Jeffrey E.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1097/PRS.0000000000004835",
language = "English (US)",
volume = "142",
pages = "21S--29S",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "3S",

}

TY - JOUR

T1 - Evidence-based strategies for the prehabilitation of the abdominal wall reconstruction patient

AU - Joslyn, Nichole A.

AU - Esmonde, Nick O.

AU - Martindale, Robert

AU - Hansen, Juliana

AU - Khansa, Ibrahim

AU - Janis, Jeffrey E.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - It is inherently challenging to achieve successful surgical outcomes for ventral hernia repairs. For complex ventral hernias, attempts to reconstruct the abdomen in patients who are overweight, deconditioned, malnourished, chronically infected or inflamed, have previous hernia recurrence, or otherwise carry a number of serious comorbidities affecting their surgical fitness are a major undertaking requiring careful preparation and planning. As the rate of abdominal wall reconstructions rises, so does the complexity of these procedures. One could argue that the prehabilitation of these patients is equally, if not more, important than the surgical technique itself. To achieve desirable outcomes and avoid surgical-site occurrences (SSOs), the surgeon must familiarize him/herself with ways to optimize a patient preoperatively. Understanding and identifying the aforementioned modifiable risk factors for SSOs is crucial. It is also important to recognize the impact that acute changes in the microbiome perioperatively can have on the postoperative success. Familiarizing oneself with the available literature for these patients is imperative. This review presents discussion and guidance for understanding the challenges and best practices for providing hernia surgery and abdominal wall reconstruction and achieving durable outcomes, with minimal SSOs.

AB - It is inherently challenging to achieve successful surgical outcomes for ventral hernia repairs. For complex ventral hernias, attempts to reconstruct the abdomen in patients who are overweight, deconditioned, malnourished, chronically infected or inflamed, have previous hernia recurrence, or otherwise carry a number of serious comorbidities affecting their surgical fitness are a major undertaking requiring careful preparation and planning. As the rate of abdominal wall reconstructions rises, so does the complexity of these procedures. One could argue that the prehabilitation of these patients is equally, if not more, important than the surgical technique itself. To achieve desirable outcomes and avoid surgical-site occurrences (SSOs), the surgeon must familiarize him/herself with ways to optimize a patient preoperatively. Understanding and identifying the aforementioned modifiable risk factors for SSOs is crucial. It is also important to recognize the impact that acute changes in the microbiome perioperatively can have on the postoperative success. Familiarizing oneself with the available literature for these patients is imperative. This review presents discussion and guidance for understanding the challenges and best practices for providing hernia surgery and abdominal wall reconstruction and achieving durable outcomes, with minimal SSOs.

UR - http://www.scopus.com/inward/record.url?scp=85061123013&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061123013&partnerID=8YFLogxK

U2 - 10.1097/PRS.0000000000004835

DO - 10.1097/PRS.0000000000004835

M3 - Article

C2 - 30138261

AN - SCOPUS:85061123013

VL - 142

SP - 21S-29S

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 3S

ER -