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O’Connor et al. Plast Aesthet Res 2019;6:26 Plastic and
DOI: 10.20517/2347-9264.2019.38 Aesthetic Research

Review Open Access

Management of post-operative complications in
open ventral hernia repair

Sean C. O’Connor, Alfredo M. Carbonell

Department of Surgery, Prisma Health-Upstate, University of South Carolina School of Medicine-Greenville, Greenville, SC 29605, USA.
Correspondence to: Dr. Alfredo M. Carbonell, Department of Surgery, Prisma Health-Upstate, University of South Carolina School of
Medicine-Greenville, 3rd Floor Support Tower, 701 Grove Rd, Greenville, SC 29605, USA. E-mail: alfredo.carbonell@prismahealth.org
How to cite this article: O’Connor SC, Carbonell AM. Management of post-operative complications in open ventral hernia repair. Plast
Aesthet Res 2019;6:26. http://dx.doi.org/10.20517/2347-9264.2019.38
Received: 10 Oct 2019 First Decision: 6 Nov 2019 Revised: 13 Nov 2019 Accepted: 15 Nov 2019 Published: 29 Nov 2019

Science Editor: Alexander F. Mericli Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract

Hernia repair is the most common general surgical procedure performed in the United States; however, historically,
there has been a surprising lack of consensus regarding hernia complications and their management. The development
of international, prospectively-collected databases such as the Americas Hernia Society Quality Collaborative has
introduced a new era of evidence-based practice around the prevention and management of these complications. This
review seeks to equip surgeons with evidence-based techniques for prevention and management of the most common
complications of open ventral hernia repair.

Keywords: Hernia repair, complications, surgical site infection, seroma, flap necrosis, mesh exposure, interparietal hernia,
recurrent hernia, enterocutaneous fistula

INTRODUCTION
Complications after hernia repair are divided into general surgical complications and hernia specific
complications. The Clavien Dindo classification system can be used to classify general surgical
[1]
complications based on severity and required interventions . The Ventral Hernia Working Group
describes hernia specific complications as surgical site occurrence (SSO) to standardize the nomenclature
when studying outcomes after hernia repair. SSO is a category of complications that includes surgical site
[2]
[3]
infection (SSI), seroma, hematoma, wound dehiscence, and enterocutaneous fistula . Petro et al. found
an association between SSO and the complexity of hernia repair using a hernia staging system that focuses
© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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