Faculty

Needs Statement

With the rise in the prevalence of obesity and the use of damage control techniques with an open abdomen approach, there has been a corresponding increase in the volume of patients with complex ventral hernias, multiple recurrent hernias, or large abdominal wall defects that are not suitable for standard hernia repair techniques. The past decade has seen a rapid increase in our understanding of functional abdominal wall anatomy, optimal techniques for abdominal wall reconstruction, and the development of new approaches to achieving primary abdominal fascial closure. There has also been an explosion in the number of synthetic mesh products available, as well as the introduction of newer tissue engineered "biologic" mesh products. This has made keeping up with the large body of literature and the newest repair techniques difficult for the average practicing surgeon. This webinar will attempt to meet these needs by providing a concise review of complex abdominal wall reconstruction, including a focus on newer reconstruction techniques and how to optimally select the type of mesh to use for repair.

Target Audience

All trauma surgeons, acute care surgeons, and practicing general surgeons who manage patients with complex or recurrent hernias or large abdominal wall defects

Objectives

Upon completion of this activity, participants will be able to:

1. Define the "complex abdominal wall reconstruction".
2. Discuss the major differences from standard incisional hernia repairs.
3. Discuss 3 different technical approaches to complex AWR.
4. Review the current data on outcomes including complications and hernia recurrence based on the location of mesh placement.
5. Discuss the differences between currently available prosthetic and biologic mesh products and provide an algorithm on selecting the appropriate product.
6. Discuss the average costs of prosthetic versus biologic products, as well as, the overall costs and beneifts considering long-term outcomes.

Accreditation

CME
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Kentucky College of Medicine, and Eastern Association for the Surgery of Trauma. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

ACGME Competencies

• Patient care
• Medical knowledge
• Practice-based learning and improvement
• Interpersonal and communication skills
• Professionalism
• Systems-based practice

Faculty Disclosure

Sean Orenstein, MD (Speaker) has relevant financial relationships with commercial interests as follows: Acelity - Instructor, Consultant, Advisory Board - Received Consultant Fee, Honorarium; Davol-Bard - Instructor, Consultant, Advisory Board - Received Consultant Fee, Honorarium

No other speakers, authors, planners or content reviewers have any relevant financial relationships to disclose. 

The material presented in this course represents information obtained from the scientific literature as well as the clinical experiences of the speakers. In some cases, the presentations might include discussion of investigational agents and/or off-label indications for various agents used in clinical practice. Speakers will inform the audience when they are discussing investigational and/or off-label uses.

Content review confirmed that the content was developed in a fair, balanced manner free from commercial bias.  Disclosure of a relationship is not intended to suggest or condone commercial bias in any presentation, but it is made to provide participants with information that might be of potential importance to their evaluation of a presentation. .

Acknowledgement

This activity is jointly provided by the University of Kentucky and Eastern Association for the Surgery of Trauma.