Preoperative patient optimization

Advances in critical care in medicine during the last three decades have made a significant impact on the management of patients with devastating surgical and vascular conditions and life-threatening injuries. Patients who survive the initial general surgery, vascular, or trauma event might require multiple trips to the operating room for management of their multiple injuries, complications, and sequelae. Subsequently, some patients develop large and complex abdominal wall defects that require surgical reconstruction. Preoperative optimization of patients requiring major abdominal wall reconstructions is of paramount importance and has been shown to reduce morbidity and mortality. This optimization should be multidisciplinary and requires attention to details; the evaluation of operative risk should be clearly discussed with the patients and close relatives.