{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:05:30Z","timestamp":1791900330913,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Concomitant panniculectomy during ventral hernia repair (VHR) remains controversial due to concerns about wound morbidity. Potential benefits include improved operative exposure and reduced abdominal wall strain. This study evaluated outcomes of VHR with and without panniculectomy in a specialised abdominal wall reconstruction unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of a prospectively maintained database of consecutive adult patients undergoing VHR with or without panniculectomy was performed. The primary outcome was hernia recurrence. Secondary outcomes included surgical site occurrence (SSO), SSO requiring procedural intervention (SSOPI), mesh infection, and length of stay (LOS). Propensity\u2010score overlap weighting adjusted for measured differences between cohorts. Time\u2010to\u2010recurrence was assessed using Kaplan\u2013Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 819 patients were included (VHR:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009341; VHR\u2009+\u2009PAN:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009478). The VHR\u2009+\u2009PAN group was younger, more often female, had higher BMI, fewer smokers, and more botulinum toxin use. Crude hernia recurrence was lower in VHR\u2009+\u2009PAN (5.6% vs. 14.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), though wound morbidity was higher (SSO: 26.4% vs. 14.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; SSOPI: 17.2% vs. 11.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040). After overlap weighting, panniculectomy remained associated with lower recurrence (aOR 0.42, 95% CI 0.19\u20130.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037) and higher SSO (aOR 2.14, 95% CI 1.18\u20133.89;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), but no significant difference in SSOPI (aOR 1.28, 95% CI 0.66\u20132.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.461). LOS was longer in VHR\u2009+\u2009PAN (adjusted ratio 1.16, 95% CI 1.07\u20131.27;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Kaplan\u2013Meier analysis confirmed higher recurrence\u2010free survival in VHR\u2009+\u2009PAN (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Concomitant panniculectomy was associated with lower hernia recurrence but higher wound morbidity and longer LOS. These findings support its feasibility in selected patients, though the observational design limits causal inference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70964","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:23:47Z","timestamp":1789003427000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Concomitant Panniculectomy During Ventral Hernia Repair: Outcomes From a High\u2010Volume Abdominal Wall Reconstruction Unit"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4546-9334","authenticated-orcid":false,"given":"Thomas G.","family":"Mackay","sequence":"first","affiliation":[{"name":"Abdominal Wall Reconstruction Unit University of Queensland, Princess Alexandra Hospital, and Greenslopes Private Hospital  Brisbane Australia"},{"name":"Medical School University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6436-5189","authenticated-orcid":false,"given":"Jai","family":"Hoff","sequence":"additional","affiliation":[{"name":"Abdominal Wall Reconstruction Unit University of Queensland, Princess Alexandra Hospital, and Greenslopes Private Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-7004","authenticated-orcid":false,"given":"Tahera","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Abdominal Wall Reconstruction Unit University of Queensland, Princess Alexandra Hospital, and Greenslopes Private Hospital  Brisbane Australia"},{"name":"Human Development and Community Wellbeing Unit The Kids Research Institute  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mairi","family":"McLaren","sequence":"additional","affiliation":[{"name":"Abdominal Wall Reconstruction Unit University of Queensland, Princess Alexandra Hospital, and Greenslopes Private Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9610-4936","authenticated-orcid":false,"given":"Kellee","family":"Slater","sequence":"additional","affiliation":[{"name":"Abdominal Wall Reconstruction Unit University of Queensland, Princess Alexandra Hospital, and Greenslopes Private Hospital  Brisbane Australia"},{"name":"Medical School University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Overweight and Obesity","author":"Australian Institute of Health and Welfare","year":"2024"},{"issue":"7","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1002\/wjs.12649","article-title":"Does BMI Impact Outcomes in Patients Undergoing Open Abdominal Wall Reconstruction? 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P.","year":"2014","journal-title":"Journal of Plastic, Reconstructive & Aesthetic Surgery"},{"issue":"1","key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s10029-021-02483-9","article-title":"Is Simultaneous Panniculectomy an Ideal Approach to Repair a Ventral Hernia: A General Surgeon's Experience","volume":"26","author":"Slater K.","year":"2022","journal-title":"Hernia"},{"issue":"2","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.jss.2012.06.029","article-title":"Comparative Study of Wound Complications: Isolated Panniculectomy Versus Panniculectomy Combined With Ventral Hernia Repair","volume":"177","author":"Zemlyak A. 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