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Background: The component separation technique (CST) is considered an excellent technique for complex ventral hernia repair. However, postoperative infectious complications and reherniation rates are significant. Risk factor analysis for postoperative complication and reherniation has focused mostly on patient history and co-morbidity and shows equivocal results. The use of abdominal morphometrics derived from CT scans to assist in risk assessment seems promising. The aim of this study is to determine the predictability of reherniation and surgical site infections (SSI) using pre-operative CT measurements.Methods: Electronic patient records were searched for patients who underwent CST between 2000 and 2013 and had a pre-operative CT scan available. Visceral fat volume (VFV), subcutaneous fat volume (SFV), loss of domain (LOD), rectus thickness and width (RT, RW), abdominal volume, hernia sac volume, total fat volume (TFV), sagittal distance (SD) and waist circumference (WC) were measured or calculated. Relevant variables were entered in multivariate regression analysis to determine their effect on reherniation and SSI as separate outcomes.Results: Sixty-five patients were included. VFV (p = 0.025, OR = 1.65) was a significant predictor regarding reherniation. Hernia sac volume (p = 0.020, OR = 2.10) and SFV per 1000 cm3 (p = 0.034, OR = 0.26) were significant predictors of SSI.Conclusion: Visceral fat volume, subcutaneous fat volume and hernia sac volume derived from CT scan measurements may be used to predict reherniation and SSI in patients undergoing complex ventral hernia repair using CST. These findings may aid in optimizing patient-tailored preoperative risk assessment. [ABSTRACT FROM AUTHOR]

The article discusses the prevention of abscess formation in an experimental model of secondary peritonitis using plasminogen activator and not a systematic antibiotic therapy. Intra-abdominal abscesses may cause recurrent or ongoing abdominal sepsis. A study conducted among male Wistar rats that were treated with antibiotics, recombinant tissue plasminogen activator or both. The study revealed that fibrinolytic therapy may be effective but antibiotics do not affect abscess formation.

Presents an abstract of the article 'Intra-Abdominal Bacterial Growth and Detection of Bacteria by Fluorescence in Situ Hybridization in Patients With Secondary Peritonitis,' by O.R. Buyne, W. Timens, K. Kooi, J. Degener, H.J.M. Harmsen and C. Rosman presented to the joint meeting of the Surgical Infection Society of Europe and the European Shock Society on May 2000 at Nijmegen, Netherlands.

Usually the choice of antibiotics for treatment of secondary peritonitis is based on the results of cultures of abdominal fluid. Despite adequate antimicrobial therapy residual or repeat infection occurs in approximately 30% of the cases. Culturing of abdominal fluid and peritoneum samples was performed by routine laboratory techniques. Fluorescence in situ hybridization was applied on human peritoneum samples to evaluate its usefulness in identifying bacteria in secondary peritonitis. Antibiotic therapy should be based on the results of the cultures of peritoneum samples rather than on the cultures of abdominal fluid.

Despite modern diagnostic and therapeutic modalities secondary peritonitis still results in up to 40% mortality. One of its sequelae, abscesses, is a potential source of recurrent or residual infection and a macroscopic sign of peritonitis. Most rodent models for peritonitis are characterized by high mortality and short duration. Researchers have examined the effects of an intraperitoneal challenge with increasing doses of bacteria in a rat model, combining low mortality with the formation of abscesses in order to characterize a stable model for secondary peritonitis.