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The effect of component separation technique on quality of life (QOL) and surgical outcomes in complex open ventral hernia repair (OVHR)

Overview of attention for article published in Surgical Endoscopy, December 2016
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Title
The effect of component separation technique on quality of life (QOL) and surgical outcomes in complex open ventral hernia repair (OVHR)
Published in
Surgical Endoscopy, December 2016
DOI 10.1007/s00464-016-5382-z
Pubmed ID
Authors

Laurel J. Blair, Tiffany C. Cox, Ciara R. Huntington, Steven A. Groene, Tanushree Prasad, Amy E. Lincourt, Kent W. Kercher, B. Todd Heniford, Vedra A. Augenstein

Abstract

Outcomes following OVHR may be affected by type of component separation. In this study, outcomes including QOL of patients undergoing OVHR were evaluated based on the utilization of transversus abdominis release (TAR), posterior rectus sheath release (PRSR) alone or in combination with external oblique release (EOR + PRSR). A prospective, single-institution study following open ventral hernia repair involving component separation was performed from May 2005 to April 2015. Self-reported QOL outcomes were obtained preoperatively and at 1, 6 and 12 months postoperatively using the Carolinas Comfort Scale (CCS). A CCS of 2 (mild but bothersome discomfort) or greater was considered symptomatic. Comorbidities, complications, outcomes and CCS scores were reviewed. Univariate group comparisons were performed using Chi-square and Wilcoxon two-sample tests with statistical significance set at p < 0.05. During the study period, 292 OVHRs with CST met inclusion criteria. Single-sided, different releases on opposite sides, etc., were eliminated. Demographics included: average age-57.9 ± 11.9 years, BMI-34.0 ± 7.9 kgm(2), 53.2% female, 69% at least one prior hernia repair and average defect size-291.2 ± 236.2 cm(2). Preoperative discomfort (82 vs. 75 vs. 79%, p = 0.77) and movement limitation (94 vs. 70 vs. 78%, p = 0.1) in TAR, PRSR and EOR + PRSR were similar. Average follow-up was 16.4 months. At 1, 6 and 12 months postoperatively, there was no difference in reported CCS pain scores, movement limitation or mesh sensation among the groups (p > 0.05). Comparing OVHR patients outcomes by CST type, TAR was associated with decreased wound infections compared to others (3.2 vs. 16.1 vs. 20%, p = 0.07) while recurrence rates were increased in EOR + PRSR compared to TAR and PRSR alone(8.4 vs. 3 vs. 1.8%, p = 0.03). Eighty percent of recurrences had a biologic mesh secondary to contaminated field during hernia repair. The other two recurrences were one which occurred superior to the mesh at a suture site and one who developed a wound infection postoperatively. Mesh infection rates were low (0 vs. 1.5 vs. 2.6%, p > 0.05) even including contaminated cases (0 vs. 2 vs. 3.6%, p > 0.05) and were statistically equivalent among all three techniques. While QOL is not impacted by type of component separation on short- or long-term follow-up, the TAR may provide benefits such as decreased wound infection rates. Overall QOL had a significant improvement from preoperative regardless of type of component separation. When controlling for field contamination, there were no differences in recurrence or infection.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 84 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 84 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 13 15%
Researcher 12 14%
Other 9 11%
Student > Master 7 8%
Student > Doctoral Student 6 7%
Other 15 18%
Unknown 22 26%
Readers by discipline Count As %
Medicine and Dentistry 49 58%
Agricultural and Biological Sciences 3 4%
Computer Science 1 1%
Arts and Humanities 1 1%
Social Sciences 1 1%
Other 1 1%
Unknown 28 33%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 January 2017.
All research outputs
#13,819,626
of 22,925,760 outputs
Outputs from Surgical Endoscopy
#3,018
of 6,076 outputs
Outputs of similar age
#218,814
of 421,458 outputs
Outputs of similar age from Surgical Endoscopy
#46
of 87 outputs
Altmetric has tracked 22,925,760 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 6,076 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 48th percentile – i.e., 48% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 421,458 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 87 others from the same source and published within six weeks on either side of this one. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.