Journal of Gastrointestinal Surgery

, Volume 18, Issue 4, pp 646–655

Prevalence of Systemic Inflammation and Micronutrient Imbalance in Patients with Complex Abdominal Hernias

  • Abby K. Geletzke
  • John M. Rinaldi
  • Brett E. Phillips
  • Sarah B. Mobley
  • Jamie Miller
  • Thomas Dykes
  • Christopher Hollenbeak
  • Shannon L. Kelleher
  • David I. Soybel
Original Article

DOI: 10.1007/s11605-013-2431-y

Cite this article as:
Geletzke, A.K., Rinaldi, J.M., Phillips, B.E. et al. J Gastrointest Surg (2014) 18: 646. doi:10.1007/s11605-013-2431-y

Abstract

Objective

To determine the prevalence of low-grade inflammation, micronutrient imbalances and associated clinical profiles in patients being evaluated for complex abdominal hernia repair.

Methods

Review of 127 consecutive adult patients for evaluation of complex ventral hernias from January 2012 to March 2013. Records were analyzed to determine the prevalence and correlations of clinical risk factors, attributes of hernias identified by computerized tomography, and laboratory indices of metabolism, inflammation and micronutrient imbalances.

Results

Strong correlations (p < 0.001) were established for body mass index (BMI) with volume of hernia content and C-reactive protein (CRP) level. CRP levels correlated strongly with red cell distribution width and inversely with zinc (p < 0.01). Evidence of micronutrient imbalance (abnormal zinc or red cell distribution width [RDW]) was observed in 48 %.

Conclusions

In this comorbidity-rich population with known variability in surgical outcomes, the prevalence of chronic inflammation and micronutrient deficiency are high enough to warrant systemic preoperative evaluation given their possible effect on wound healing and convalescence. Simple repletion is unlikely to improve outcomes without attention to the biological stresses that are associated with micronutrient imbalance.

Keywords

Ventral hernia Incisional hernia Zinc Micronutrients C-reactive protein 

Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Abby K. Geletzke
    • 1
  • John M. Rinaldi
    • 1
  • Brett E. Phillips
    • 1
  • Sarah B. Mobley
    • 1
  • Jamie Miller
    • 1
  • Thomas Dykes
    • 2
  • Christopher Hollenbeak
    • 1
    • 3
  • Shannon L. Kelleher
    • 1
    • 4
    • 5
  • David I. Soybel
    • 1
    • 4
  1. 1.Department of Surgery,College of MedicineThe Pennsylvania State UniversityHersheyUSA
  2. 2.Department of Radiology, College of MedicineThe Pennsylvania State UniversityHersheyUSA
  3. 3.Department of Public Health Sciences, The Pennsylvania State UniversityCollege of MedicineHersheyUSA
  4. 4.Department of Cell and Molecular Physiology, College of MedicineThe Pennsylvania State UniversityHersheyUSA
  5. 5.College of Health and Human DevelopmentPenn State UniversityUniversity ParkUSA

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