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Hernia Grading System of Breuing et al (Ventral Hernia Working Group)

Purpose: To evaluate a patient prior to repair of an incisional ventral hernia using the Hernia Grading System of Breuing et al (Ventral Hernia Working Group).

Description

Breuing et al reported a grading system for ventral hernias that can help to predict surgical site occurrences (SSO). The surgical approach may vary with the likelihood of surgical site infection or other postoperative complications. The authors are members of the Ventral Hernia Working Group from multiple hospitals in the United States.


Patient selection: incisional ventral hernia repair

 

Outcome: risk for surgical site occurrence (SSO) such as surgical site infection

 

Clinical Findings

Grade

infected mesh

4

septic dehiscence

4

history of previous wound infection

3

stoma present

3

violation of the gastrointestinal tract

3

comorbid conditions present (see below)

2

none of the above

1

 

Comorbid conditions:

(1) smoker

(2) obese

(3) COPD

(4) diabetes mellitus

(5) immunocompromised, immunosuppressed

 

Grade

Risk for SSO

1

low

2

low to moderate

3

moderate to high (potentially contaminated)

4

high (infected)

 


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Specialty

Objective

ICD-10