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Shao et al. Plast Aesthet Res 2020;7:21 Plastic and
DOI: 10.20517/2347-9264.2020.04 Aesthetic Research

Perspective Open Access

Establishing a center of excellence in abdominal
wall reconstruction

Jenny Shao, Sharbel Elhage, Eva Deerenberg, Vedra Augenstein, B. Todd Heniford

Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC 28204, USA.
Correspondence to: Dr. B. Todd Heniford, Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, 1025
Morehead Medical Drive Suite 300, Charlotte, NC 28204, USA. E-mail: todd.heniford@gmail.com

How to cite this article: Shao J, Elhage S, Deerenberg E, Augenstein V, Heniford BT. Establishing a center of excellence in abdominal
wall reconstruction. Plast Aesthet Res 2020;7:21. http://dx.doi.org/10.20517/2347-9264.2020.04

Received: 3 Jan 2020 First Decision: 10 Apr 2020 Revised: 13 Apr 2020 Accepted: 16 Apr 2020 Published: 25 Apr 2020
Science Editor: Sahil Kuldip Kapur Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Building a tertiary referral center of excellence for complex abdominal wall reconstruction is a multi-step process
that requires many elements to garner and promote success. Ultimately the creation of such a center is important
for continual improvement of abdominal wall reconstruction outcomes by decreasing complications, recurrences,
length of hospital stay, hospital readmissions, and overall costs. Establishing a center of excellence incorporates
several key components including the surgeon’s desires and expertise, institutional participation, multidisciplinary
collaboration, outcomes research and innovation, and financial stability. This article outlines the principal
elements of building a sustainable, functional, and successful center of excellence for complex abdominal wall
reconstruction.

Keywords: Complex abdominal wall reconstruction, center of excellence

INTRODUCTION
Over 1 million hernia surgeries are performed in the United States annually, making hernia repair the most
[1-3]
common general surgery procedure performed by surgeons across the country . Hernias occur due to
a variety of factors, including prior abdominal surgery, increased intraabdominal pressure secondary to
chronic cough or obesity, and compromised connective tissue integrity as a result of genetics, infection and
other factors. The incidence of abdominal hernia needing surgery is estimated to be as high as 20%-30%
[4-7]
in the literature . Due to the large number of patients requiring hernia repair, it is estimated that a 1%
[1]
reduction in hernia recurrence would save $32 million annually in healthcare . While personal health
consequences are supremely important, these data highlight the significant financial implications for
both hospitals and patients in hernia prevention and durability of repair. Of those patients undergoing

© The Author(s) 2020. 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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