• Amy Gin Gossett, Justin D Leavitt, W Borden Hooks, and William W Hope.
• Department of Surgery, New Hanover Regional Medical Center, Novant Health, Wilmington, NC.
• J. Am. Coll. Surg. 2025 Jan 16.

BackgroundPatients with large pannus and ventral hernias may benefit from undergoing panniculectomy performed concurrently with open ventral hernia repair (VHR-PAN). However, there has been concerns related to increase surgical site occurrences when adding a panniculectomy. This study aims to evaluate outcomes of open VHR with and without panniculectomy using a large hernia specific database.Study DesignThe Abdominal Core Health Quality Collective (ACHQC) database was queried from 2012 to 2023 for patients who underwent VHR-only vs VHR-PAN. Patient and surgical characteristics were described and compared. Short-term outcomes including surgical site infection (SSI), surgical site occurrence (SSO), and SSO requiring procedural intervention (SSOPI) were compared. Patient reported outcomes (PROs) and hernia recurrence were compared at 1 year. Logistic regression was used to identify risks associated with the above outcomes.ResultsThere were 28,140 patients who underwent open VHR, 2108 where panniculectomy data were included (yes or no), and 870 who underwent VHR-PAN. Patients who underwent VHR-PAN were more likely to be female,78.3% vs 64.8% (p < 0.0001), have a BMI over 40, 21.0% vs 7.8% (p < 0.0001) with greater median hernia width, 10.0 [7.0, 15.0] vs 8.0 [3.0, 13.0] (p < 0.0001). In a matched analysis, there was no significant difference in SSI, SSO, SSOPI, or 1 year hernia recurrences rates in the VHR-PAN group (p<0.05).ConclusionThis study demonstrated that VHR with concurrent panniculectomy is not significantly associated with an increased risk of complications. Concurrent panniculectomy can be considered for selected patients needing VHR.Copyright © 2025 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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