Strategies for operative management of abdominal wall hernia after solid organ transplant

• 作者: Devinder Singh Luther Holton Lauren Antognoli Salman Choudhry
• 来源期刊: 整形与美容研究（英文版）
• 年，卷（期）: 2020,（7）
• 所属期刊栏目: Review
• 页码范围: 49-61
• 页数: 13页
• 语种: 英文
• DOI: 10.20517/2347-9264.2019.76

摘要

About 5％-11％ of all abdominal surgery results in incisional hernia. This rate can be even higher among high-risk populations such as transplant patients. Lifetime incidence of incisional hernia following liver transplant is as high as 43％ in recent studies. The transplant population is at higher risk for incisional hernia precisely because of their immunosuppressive therapy. Thus, it is imperative to understand the risk factors for incisional hernia in this unique patient population. This article focuses on understanding preoperative, intraoperative, and postoperative risk factors for failure of hernia repair in the transplant population in addition to discussing risk stratification for incisional hernia in this population. Furthermore, we discuss the utility of panniculectomy in abdominal organ transplantation. Additionally, we discuss the value of mesh placement in abdominal wall closure. Finally, we review the concept of vascularized composite allograft as a method for achieving abdominal wall closure for patients who have failed more traditional repairs and who are left with inadequate tissue for successful repair.