采用脱细胞真皮基质的开放式、单阶段择期腹壁重建术后的住院再入院会影响长期疝复发率。
Hospital readmission following open, single-stage, elective abdominal wall reconstructions using acellular dermal matrix affects long-term hernia recurrence rate.
机构信息
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
出版信息
Am J Surg. 2018 Jul;216(1):60-66. doi: 10.1016/j.amjsurg.2018.01.072. Epub 2018 Feb 5.
BACKGROUND
We evaluated the incidence of and the risk factors for readmission in patients who underwent abdominal wall reconstruction (AWR) using acellular dermal matrix (ADM) and assess whether readmission affects AWR long-term outcomes.
METHODS
A retrospective, single-center study of patients underwent AWR with ADM was conducted. The primary outcome was the incidence of unplanned readmission within 30 days after the initial discharge post-AWR. Secondary outcomes were surgical site occurrence (SSO) and hernia recurrence at follow-up.
RESULTS
Of 452 patients (mean age, 59 years; mean follow-up, 35 months), 29 (6.4%) were readmitted within 30 days. Most readmissions were due to SSO (44.8%) or wound infections (12.8%). The hernia recurrence rate was significantly higher in readmitted patients (17.2% vs 9.9%; P = 0.044). Wider defects, prolonged operative time, and coronary artery disease were independent predictors of readmission.
CONCLUSIONS
Readmission is associated with hernia recurrence on long-term follow-up. SSO is the most common cause for readmission.
背景
我们评估了使用脱细胞真皮基质（ADM）进行腹壁重建（AWR）的患者的再入院发生率和相关风险因素，并评估再入院是否会影响 AWR 的长期结果。
方法
对接受 ADM 行 AWR 的患者进行了回顾性单中心研究。主要结局是 AWR 初始出院后 30 天内计划外再入院的发生率。次要结局是随访时的手术部位发生（SSO）和疝复发。
结果
452 例患者（平均年龄 59 岁；平均随访 35 个月）中，29 例（6.4%）在 30 天内再入院。大多数再入院是由于 SSO（44.8%）或伤口感染（12.8%）。再入院患者的疝复发率显著更高（17.2% vs 9.9%；P=0.044）。更大的缺损、手术时间延长和冠状动脉疾病是再入院的独立预测因素。
结论
再入院与长期随访时的疝复发相关。SSO 是再入院的最常见原因。
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