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Definitions for Loss of Domain: An International Delphi Consensus of Expert Surgeons

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  • Samuel G Parker
  • Steve Halligan
  • Mike K Liang
  • Filip E Muysoms
  • Gina L Adrales
  • Adam Boutall
  • Andrew C de Beaux
  • Ulrich A Dietz
  • Celia M Divino
  • Mary T Hawn
  • Todd B Heniford
  • Joon P Hong
  • Nabeel Ibrahim
  • Kamal M F Itani
  • Lars N Jorgensen
  • Agneta Montgomery
  • Salvador Morales-Conde
  • Yohann Renard
  • David L Sanders
  • Neil J Smart
  • Jared J Torkington
  • Alastair C J Windsor
Vis graf over relationer

BACKGROUND: No standardized written or volumetric definition exists for 'loss of domain' (LOD). This limits the utility of LOD as a morphological descriptor and as a predictor of peri- and postoperative outcomes. Consequently, our aim was to establish definitions for LOD via consensus of expert abdominal wall surgeons.

METHODS: A Delphi study involving 20 internationally recognized abdominal wall reconstruction (AWR) surgeons was performed. Four written and two volumetric definitions of LOD were identified via systematic review. Panelists completed a questionnaire that suggested these definitions as standardized definitions of LOD. Consensus on a preferred term was pre-defined as achieved when selected by ≥80% of panelists. Terms scoring <20% were removed.

RESULTS: Voting commenced August 2018 and was completed in January 2019. Written definition: During Round 1, two definitions were removed and seven new definitions were suggested, leaving nine definitions for consideration. For Round 2, panelists were asked to select all appealing definitions. Thereafter, common concepts were identified during analysis, from which the facilitators advanced a new written definition. This received 100% agreement in Round 3. Volumetric definition: Initially, panelists were evenly split, but consensus for the Sabbagh method was achieved. Panelists could not reach consensus regarding a threshold LOD value that would preclude surgery.

CONCLUSIONS: Consensus for written and volumetric definitions of LOD was achieved from 20 internationally recognized AWR surgeons. Adoption of these definitions will help standardize the use of LOD for both clinical and academic activities.

OriginalsprogEngelsk
TidsskriftWorld Journal of Surgery
Vol/bind44
Udgave nummer4
Sider (fra-til)1070-1078
Antal sider9
ISSN0364-2313
DOI
StatusUdgivet - apr. 2020

ID: 62416561