The use of component separation during abdominal wall reconstruction in contaminated fields: A case-control analysis

Component separation technique (CST) allows fascial medialization during abdominal wall reconstruction (AWR). Wound contamination increases the incidence of wound complications, which multiplies the incidence of repair failure. The aim of this study was to compare the impact of CST on AWR outcomes in contaminated fields in comparison to those operations without CST. A prospective, single institution hernia database was queried for patients undergoing AWR with CST and contamination. A case control cohort was identified using propensity score matching. There were 286 CSTs performed in contaminated cases. After propensity score matching, 61 CSTs were compared to 61 No-CSTs. These groups were matched by defect area (CST:287.1 ± 150.4 vs No-CST:277.6 ± 218.4 cm2, p = 0.156), BMI (32.0 ± 7.0 vs 32.2 ± 6.0 kg/m2, p = 0.767), diabetes (26.2% vs 32.8%, p = 0.427), and panniculectomy (52.5% vs 36.1%, p = 0.068). Groups had similar rates of wound complications (42.6% vs 40.7%, p = 0.829) and recurrence (4.9% vs 13.1%, p = 0.114). The use of CST in the face of contamination is not associated with an increase in wound complications, mesh complications, or recurrence. •This is a propensity score matching study finding similar results in AWR with and without component separation.•The data shows similar wound complications, hernia recurrences, and mesh infections in both groups.•This suggests that the use of component separation techniques in contaminated wounds is safe and effective in hernia repair. This study is a tertiary center, prospective cohort analysis of abdominal wall reconstruction with and without component separation in contaminated cases. The data show no increased wound complications or hernia recurrence when performing component separation.