Comprehensive Hernia Center Digestive Disease and Surgery Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Comprehensive Hernia Center Digestive Disease and Surgery Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Am J Surg. 2019 Sep;218(3):560-566. doi: 10.1016/j.amjsurg.2019.01.022. Epub 2019 Jan 25.
There is a paucity of data delineating the relationship between body mass index (BMI) and wound complications. We investigated the association between BMI and wound morbidity following open ventral hernia repair with mesh (OVHR).
Patients undergoing elective OVHR were identified within the Americas Hernia Society Quality Collaborative. Multivariate logistic regression identified predictors of 30-day surgical site infection (SSI) and surgical site occurrences requiring procedural intervention (SSOPI). BMI was treated as a continuous variable in the models.
8949 patients were included (median age 58, median BMI 31.3 kg/m, median defect width of 7 cm). Repairs typically included synthetic mesh (89%), placed as a sublay (70%). SSI rate was 4.5% and SSOPI was 6.7%. BMI was associated with increased relative log-odds for SSI (p = 0.01) and SSOPI (<0.0001), with a proportional increase in relative log-odds for complications according to escalations in BMI.
Escalating BMI progressively increases relative log-odds for SSI and SSOPI after OVHR. Further studies are necessary to determine whether preoperative weight loss can reduce the impact of this association.
目前缺乏明确 BMI（体重指数）与伤口并发症之间关系的数据。我们研究了在使用网片行开放式腹疝修补术（OVHR）后 BMI 与伤口发病率之间的关系。
在美国疝学会质量协作组内确定接受择期 OVHR 的患者。多变量逻辑回归确定了 30 天内手术部位感染（SSI）和需要手术干预的手术部位事件（SSOPI）的预测因素。在模型中，BMI 被视为连续变量。
共纳入 8949 例患者（中位年龄 58 岁，中位 BMI 为 31.3kg/m2，中位缺损宽度为 7cm）。修复通常包括合成网片（89%），作为层铺（70%）放置。SSI 发生率为 4.5%，SSOPI 为 6.7%。BMI 与 SSI（p=0.01）和 SSOPI（<0.0001）的相对对数优势增加相关，随着 BMI 的升高，并发症的相对对数优势呈比例增加。
OVHR 后，BMI 逐渐升高与 SSI 和 SSOPI 的相对对数优势增加相关。需要进一步研究以确定术前减重是否可以降低这种关联的影响。
