Hernia Treatment: 4 Steps to Successful Abdominal Wall Reconstruction

can be performed on an emergency or elective basis. A patient showing signs of

usually requires urgent surgery. When dealing with such patients, the clinician

as the risks of delaying the operation are extremely high. On the other hand, the vast

with abdominal wall defects do not show such alarming symptoms. They may experience

and inability to perform certain activities of daily living due to a large hernia. And in this case, the surgeon has the opportunity to

to obtain the best result of the operation.

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As a result of the reconstruction, the surgeon must obtain a strong, dynamic and durable abdominal wall, which is usually achieved through the use of special meshes.

The surgeon should also strive to

which can be divided into 3 categories:

• medical complications;
• hematomas, seromas, skin necrosis
• mother and others

Ideal tummy: main features of tummy tuck Principles for performing safe and effective abdominal wall reconstruction

Smoking.
Smoking, by reducing tissue perfusion and oxygenation, impairs wound healing. Quitting smoking 4 weeks before and after surgery significantly reduces the risk of infection and other complications;

Malnutrition.
•  
Protein malnutrition, especially arginine and methionine deficiencies, is associated with significantly higher mortality. In addition, low albumin levels are associated with a 10-fold increased risk of infection;

Obesity.
Not only does obesity increase the risk of hematomas and seromas, but it has also been shown to increase the risk of hernia recurrence.

Diabetes mellitus.
Poorly controlled diabetes mellitus is another risk factor for complications. Even infrequent hyperglycemias reduce tissue perfusion and impair immune function.

To minimize the risk of hernia recurrence, it is necessary to achieve

, while removing all non-viable and scar tissues, and fix it with mesh. At the same time,

. Excessive tension on the edges of the defect can cause fascial dehiscence and recurrence of the hernia.

As a general rule,

to avoid ripples or wrinkles.

. Meshes can be broadly divided into

and biological.

, however biological meshes tend to be better embedded and more resistant to infection. Recent data suggest that the porosity and weight of the synthetic mesh are important factors when it comes to integration

tend to suffer more from failure and heavy microporous meshes more often associated with scarring and infection.

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Preservation of the vascular system of the skin and soft tissues is important to reduce the risk of complications.  Therefore, it is desirable that access be as minimally traumatic as possible.

For a patient who is undergoing a complex abdominal wall reconstruction,

is as important to the final result as the operation itself. Increased intra-abdominal pressure after reconstruction puts the patient at high risk for venous thromboembolism, atelectasis, and pneumonia.

To minimize the risk of venous thromboembolism, the patient must

. It is advisable to start physical activity in the evening after the operation. Adequate

is important to achieve early patient recovery.

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