Modified Hernia Grading Scale to Stratify Surgical Site Occurrence after Open Ventral Hernia Repairs

Kanters, Arielle; Krpata, David M.; Blatnik, Jeffrey A.; Novitsky, Yuri M.; Rosen, Michael J.

doi:10.1016/j.jamcollsurg.2012.08.012

Cited by 280 publications

(168 citation statements)

References 18 publications

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“…The model demonstrated little loss of information (AIC = 87.47) and an adequate goodness of fit (HosmerLemeshow test p = 0.097) [4]. All variables used to define the VHRS were found to be independent predictors of SSI (Tables 4 and 5) [4]. A ROC curve (Fig.…”

Section: Validation Of Vhrs For Site Infectionsmentioning

confidence: 95%

“…Several classification systems have been developed to quantify patient and operative factors that predict poor outcomes. The Ventral Hernia Working Group (VHWG) and the U.S. Centers for Disease Control and Prevention (CDC) incision class are models for stratifying patient risk for SSI [3,4]. Previously, we reported that the Ventral Hernia Risk Score (VHRS) was more accurate in a Veterans Affairs (VA) population in predicting SSI after open ventral hernia repair (VHR) than were other models such as the VHWG.…”

mentioning

confidence: 99%

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External Validation of the Ventral Hernia Risk Score for Prediction of Surgical Site Infections

Liang¹,

Goodenough²,

Martindale

et al. 2015

Surgical Infections

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Background: Previously, we reported that the Ventral Hernia Risk Score (VHRS) was more accurate in a Veterans Affairs (VA) population in predicting surgical site infection (SSI) after open ventral hernia repair (VHR) compared with other models such as the Ventral Hernia Working Group (VHWG) model. The VHRS was developed using single-center data and stratifies SSI risk into five groups based on concomitant hernia repair, skin flaps created, American Society of Anesthesiologists (ASA) score ‡ 3, body mass index ‡ 40 kg/m

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Section: Validation Of Vhrs For Site Infectionsmentioning

confidence: 95%

mentioning

confidence: 99%

External Validation of the Ventral Hernia Risk Score for Prediction of Surgical Site Infections

Liang¹,

Goodenough²,

Martindale

et al. 2015

Surgical Infections

View full text Add to dashboard Cite

show abstract

“…Before introducing a new grading system, it has to be validated. The VHWG grading system has been questioned by one of the authors in a recent paper using the grading scale retrospectively in 299 patients analyzing the accuracy of the scale to predict SSOs [15]. A modification into a 3-grade…”

Section: Recommendationsmentioning

confidence: 99%

The battle between biological and synthetic meshes in ventral hernia repair

Montgomery

2013

Hernia

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“…Biologic mesh derived from extracellular matrix (ECM) is preferred over synthetic mesh in these cases, particularly in infected or contaminated abdominal fields. 7,8 Dermis is one of the biologic grafts that has been widely used because it has similar mechanical properties as the native abdominal wall, and it is known to be vascularized and serve as a scaffold for constructive remodeling and native tissue regeneration. [9][10][11][12] However, repair outcomes using dermis grafts in large, complex hernias have generally been poor, even after performing additional soft tissue closures.…”

Section: Introductionmentioning

confidence: 99%

Investigating muscle regeneration with a dermis/small intestinal submucosa scaffold in a rat full‐thickness abdominal wall defect model

Sahoo

Baker

et al. 2014

J Biomed Mater Res

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Repair of large complex ventral wall hernias is challenging and outcomes are often poor due to hernia recurrence and compromised abdominal wall function. Currently, biological grafts are used to assist in repairing these complex hernias. Dermis grafts are often chosen because of their mechanical characteristics; however, dermis does not have the ability to promote the muscle regeneration needed to regain abdominal wall function. In contrast, small intestinal submucosa (SIS) grafts have been shown to promote muscle generation in volumetric muscle loss (VML) models. Hence, the objective of this study is to investigate the extent to which SIS grafts can be used together with dermis grafts to repair and promote muscle regeneration in a full-thickness abdominal wall defect in a rat model. The dermis layer is intended to mechanically bridge the defect and support constructive tissue remodeling while the SIS is intended to degrade and promote neo-muscle formation. After 16 weeks of implantation, we found only a small amount of vascularized muscle (<10% of the defect area) in the repaired defects. No significant difference in defect muscle area was found between the groups receiving the dermis + SIS scaffolds and the control (dermis alone) group. Our findings indicate that the SIS constructions investigated could not promote appreciable muscle regeneration in this rigorous animal model of VML and incomplete abdominal closure. Future investigation into combination scaffold, cell and molecular therapies would be warranted to address the need for functional muscle regeneration in challenging clinical conditions such as complex abdominal wall repair.

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Modified Hernia Grading Scale to Stratify Surgical Site Occurrence after Open Ventral Hernia Repairs

Cited by 280 publications

References 18 publications

External Validation of the Ventral Hernia Risk Score for Prediction of Surgical Site Infections

External Validation of the Ventral Hernia Risk Score for Prediction of Surgical Site Infections

The battle between biological and synthetic meshes in ventral hernia repair

Investigating muscle regeneration with a dermis/small intestinal submucosa scaffold in a rat full‐thickness abdominal wall defect model

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