In their BTK debut, the Hernia team from Carolinas Medical Center discusses how to approach a hernia patient with loss of domain. This Clinical Challenges episode reviews strategies that optimize patients and provide them with the best chance of fascial closure. So, tune in, and enjoy a data driven conversation with our newest hernia enthusiasts! 

Hosts:
- Sullivan "Sully" Ayuso, MD - PGY4 General Surgery Resident, sullivan.ayuso@gmail.com, Carolinas Medical Center 
- Monica Polcz, MD - Clinical Fellow (PGY-8) in Abdominal Wall Reconstruction, monica.polcz@atriumhealth.org, Carolinas Medical Center 
- Vedra Augenstein, MD FACS - Associate Professor of Surgery (11 years in practice), vedra.augenstein@gmail.com, Carolinas Medical Center B 
- Todd Heniford, MD FACS - Professor of Surgery (25 years in practice), todd.heniford@gmail.com, Carolinas Medical Center

Links to articles:
- Katzen et al, Open Preperitoneal Ventral Hernia Repair: Prospective Observational Study of Quality Improvement Outcomes over 18 Years and 1,842 patients, Surgery, 2022
https://pubmed.ncbi.nlm.nih.gov/36280505/ 
- Bernardi et al, Primary Fascial Closure During Laparoscopic Ventral Hernia Repair Improves Patient Quality of Life: A Multicenter, Blinded Randomized Trial, Ann Surg, 2020
https://pubmed.ncbi.nlm.nih.gov/31365365/ 
- Deerenberg et al, The Effects of Preoperative Botulinum Toxin A on Abdominal Wall Reconstruction, J Surg Res, 2021
https://pubmed.ncbi.nlm.nih.gov/33360691/ 
- Bueno-Lledó, Preoperative Progressive Pneumoperitoneum and Botulinum Toxin A in Patients with Large Incisional Hernia, Hernia, 2017
https://pubmed.ncbi.nlm.nih.gov/28124308/ 
- Maloney et al, Twelve Years of Component Separation Technique in Abdominal Wall Reconstruction, Surgery, 2021
https://pubmed.ncbi.nlm.nih.gov/31358348/ 
- Ayuso et al, Delayed Primary Closure (DPC) of the Skin and Subcutaneous Tissues Following Complex, Contaminated Abdominal Wall Reconstruction (AWR): A Propensity-Matched Study, Surg Endo, 2022
https://pubmed.ncbi.nlm.nih.gov/34018046/

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

If you liked this episode, check out more hernia episodes here: https://behindtheknife.org/podcast-category/hernia/