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Older age only independent risk factor for hernia repair after breast reconstruction

After abdominal flap breast reconstruction, researchers found the overall hernia repair rate within 3 years was 2.45%, compared with 0.28% among women who had mastectomy only.

The study included women with breast cancer who underwent mastectomy and were grouped into four categories: mastectomy alone, or mastectomy with one of three types of autologous flap reconstruction: pedicled transverse rectus abdominis myocutaneous (TRAM), free TRAM or deep inferior epigastric perforator (DIEP) flaps.

The mastectomy-only group included 15,679 women who made up the control group and 7,929 women who underwent pedicled TRAM, free TRAM or DIEP flap procedures.

Unilateral and bilateral procedures and immediate and delayed reconstructions were included in the study.

Forty-one women (0.28%) in the control group underwent hernia repair within 3 years.

In the reconstruction group, 149 women underwent hernia repair within 3 years, a rate that was at least eight times greater (2.45%).

Umbilical hernia repairs were the most common procedure in the control group, accounting for 51% of repairs. Among the reconstruction patients, ventral hernia repair was the most common repair in DIEP flap patients (46%), and incisional repairs were most common among free TRAM flap patients (52%) and pedicled TRAM flap patients (50%).

Mean time to first hernia repair was 17.7 months after abdominal flap harvest.

The only risk of subsequent hernia repair was age at time of reconstruction, with an increased risk seen among women older than 60 years.

Those who underwent free TRAM or pedicled TRAM flap surgery had an increased risk relative to women who underwent DIEP flap reconstructions.

Researchers found no association between risk for hernia repair and obesity, diabetes, year of reconstruction or bilateral harvest. – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.