Preoperative risk reduction: strategies to optimize outcomes

Surg Clin North Am. 2013 Oct;93(5):1041-55. doi: 10.1016/j.suc.2013.06.015. Epub 2013 Aug 6.

Abstract

The success of hernia repair is measured by absence of recurrence, appearance of the surgical scar, and perioperative morbidity. Perioperative surgical site occurrence (SSO), defined as infection, seroma, wound ischemia, and dehiscence, increases the risk of recurrent hernia by at least 3-fold. The surgeon should optimize all measures that promote healing, reduce infection, and enhance early postoperative recovery. In the population with ventral hernia, the most common complication in the immediate perioperative period is surgical site infection. This article reviews several preoperative measures that have been reported to decrease SSOs and shorten length of hospital stay.

Keywords: Hernia repair; Intervention; Obesity; Perioperative morbidity; Surgical site infection.

Publication types

  • Review

MeSH terms

  • Antibiotic Prophylaxis
  • Antisepsis
  • Diet
  • Hernia, Ventral / complications
  • Hernia, Ventral / prevention & control
  • Hernia, Ventral / surgery*
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / prevention & control
  • Nutritional Support
  • Obesity / complications
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Preoperative Care / methods*
  • Risk Factors
  • Risk Reduction Behavior
  • Secondary Prevention
  • Smoking Cessation
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control