This study, which looks at the effects of transversus abdominis muscle release with bridge supported by a retro-muscular mesh in the posterior component separation used to treat abdominal wall dehiscence, addresses a research gap by retrospective examining multiple hospitals

Abstract

Abstract Setting This investigation looked at the consequences of neuromuscular mesh reinforcing following posterior component separation (CS) and transversus abdominis muscle release (TAR) in patients with primary abdominal wall dehiscence (AWD). The frequency of incisional hernias (IH) at the area of operation following AWD restoration with posterior CS and TAR strengthened by neuromuscular mesh, as well as the potential variables for IH, served as the other goals. Methods The time frame for this prospective, multicenter cohort study was April 2015–January 2020. A total of 404 individuals administered posterior CS with TAR release supported by a neuromuscular mesh had median laparotomies and were identified with category IA primary AWD (Björck's first categorization). Results The mean age of the group was 42 ± 10 years, with women making up 59.9% of the total. From the midline laparotomy index surgery to the primary AWD, the average time was 7 ± 3 days. The vertical length had an average of 16 ± 2 cm. The average time interval between the onset of AWD and the posterior CS + TAR procedure was 3.1 ± 1 days. The average duration of operation for posterior CS with TAR was 95 ± 12 min. The AWD did not reappear. The percentages of cases with seroma, hemorrhage-contaminated mesh, infection from the surgical site (SSI), and IH were 7.9%, 12.4%, 2%, 8.9%, and 3%, respectively. 2.5% of mortality was recorded in total. Old age, sex, cigarettes, albumin value < 3.5 gm%, SSI, ileus, contaminated mesh, and the time between AWD and posterior CS + TAR with bridge surgery were significantly more common in IH patients. IH rates were 0.5% and 8.9% at 2 and 3 years, respectively. Ileus, SSI, contaminated mesh, and the interval between AWD and posterior CS + TAR operations were identified as variables that indicated IH in multivariate logistic regression analysis. Conclusions When posterior CS with TAR and retro-muscular mesh implants were combined, the low mortality rate was 2.5%. Additionally, minimal relapse rates of AWD and IH were noted.