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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 4/2014

01-04-2014 | Original Article

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

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

Published in: Journal of Gastrointestinal Surgery | Issue 4/2014

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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.
Literature
1.
Le Huu Nho R, Mege D, Ouaïssi M, Sielezneff I, Sastre B. Incidence and prevention of ventral incisional hernia. J Visc Surg 2012;149(5 Suppl):e3–e14.PubMedCrossRef
2.
Flum DR, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 2003;237(1):129–135.PubMedCrossRefPubMedCentral
3.
Helgstrand F, Rosenberg J, Kehlet H, Jorgensen LN, Bisgaard T. Nationwide prospective study of outcomes after elective incisional hernia repair. J Am Coll Surg 2013;216(2):217–228.
4.
Ghazi B, Deigni O, Yezhelyev M, Losken A. Current options in the management of complex abdominal wall defects. Ann Plast Surg 2011;66(5):488–492.PubMedCrossRef
5.
Hadeed JG, Walsh MD, Pappas TN, Pestana IA, Tyler DS, Levinson H, Mantyh C, Jacobs DO, Lagoo-Deenadalayan SA, Erdmann D. Complex abdominal wall hernias: a new classification system and approach to management based on review of 133 consecutive patients. Ann Plast Surg 2011;66(5):497–503.PubMedCrossRef
6.
Dietz UA, Winkler MS, Hartel RW, Fleischhacker A, Wiegering A, Isbert C, Jurowich C, Heuschmann P, Germer CT. Importance of recurrence rating, morphology, hernial gap size, and risk factors in ventral and incisional hernia classification. Hernia 2012. doi:10.​1007/​s10029-012-0999-x.
7.
Heartsill L, Richards ML, Arfai N, Lee A, Bingener-Casey J, Schwesinger WH, Sirinek KR. Open Rives–Stoppa ventral hernia repair made simple and successful but not for everyone. Hernia 2005;9(2):162–166.PubMedCrossRef
8.
Iqbal CW, Pham TH, Joseph A, Mai J, Thompson GB, Sarr MG. Long-term outcome of 254 complex incisional hernia repairs using the modified Rives–Stoppa technique. World J Surg 2007;31(12):2398–2404.PubMedCrossRef
9.
Williams RF, Martin DF, Mulrooney MT, Voeller GR. Intraperitoneal modification of the Rives–Stoppa repair for large incisional hernias. Hernia 2008;12(2):141–145.PubMedCrossRef
10.
Ko JH, Wang EC, Salvay DM, Paul BC, Dumanian GA. Abdominal wall reconstruction: lessons learned from 200 "components separation" procedures. Arch Surg 2009;144(11):1047–1055.PubMedCrossRef
11.
Hultman CS, Tong WM, Kittinger BJ, Cairns B, Overby DW, Rich PB. Management of recurrent hernia after components separation: 10-year experience with abdominal wall reconstruction at an academic medical center. Ann Plast Surg 2011;66(5):504–507.PubMedCrossRef
12.
Satterwhite TS, Miri S, Chung C, Spain D, Lorenz HP, Lee GK. Outcomes of complex abdominal herniorrhaphy: experience with 106 cases. Ann Plast Surg 2012;68(4):382–388.PubMedCrossRef
13.
Dunne JR, Malone DL, Tracy JK, Napolitano LM. Abdominal wall hernias: risk factors for infection and resource utilization. J Surg Res 2003;111(1):78–84.PubMedCrossRef
14.
Finan KR, Vick CC, Kiefe CI, Neumayer LA, Hawn MT. Predictors of wound infection in ventral hernia repair. Am J Surg 2005;190(5):676–681.PubMedCrossRef
15.
Mason RJ, Moazzez A, Sohn HJ, Berne TV, Katkhouda N. Laparoscopic versus open anterior abdominal wall hernia repair: 30-day morbidity and mortality using the ACS–NSQIP databa. Ann Surg 2011;254(4):641–652.PubMedCrossRef
16.
Mayo NE, Feldman L, Scott S, Zavorsky G, Kim do J, Charlebois P, Stein B, Carli F. Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery. Surgery 2011;150(3):505–514.PubMedCrossRef
17.
Jack S, West M, Grocott MP. Perioperative exercise training in elderly subjects. Best Pract Res Clin Anaesthesiol 2011;25(3):461–472.PubMedCrossRef
18.
Johnson AR, Milner JJ, Makowski L. The inflammation highway: metabolism accelerates inflammatory traffic in obesity. Immunol Rev 2012;249(1):218–238.PubMedCrossRefPubMedCentral
19.
Provinciali M, Cardelli M, Marchegiani F. Inflammation, chronic obstructive pulmonary disease and aging. Curr Opin Pulm Med 2011;17(Suppl 1):S3–S10.PubMedCrossRef
20.
Fagundes CP, Glaser R, Hwang BS, Malarkey WB, Kiecolt-Glaser JK. Depressive symptoms enhance stress-induced inflammatory responses. Brain Behav Immun 2013;31:172–6.PubMedCrossRef
21.
Rawdin B, Mellon SH, Dhabhar FS, Epel ES, Puterman E, Su Y, Burke HM, Reus VI, Rosser R, Hamilton SP, Nelson JC, Wolkowitz OM. Dysregulated relationship of inflammation and oxidative stress in major depression. Brain Behav Immun 2013;31:143–152.
22.
Ströhle A, Wolters M, Hahn A. Micronutrients at the interface between inflammation and infection—ascorbic acid and calciferol: Part 1. General overview with a focus on ascorbic acid. Inflamm Allergy Drug Targets 2011;10(1):54–63.CrossRef
23.
Ströhle A, Wolters M, Hahn A. Micronutrients at the interface between inflammation and infection—ascorbic acid and calciferol: Part 2. Calciferol and the significance of nutrient supplements. Inflamm Allergy Drug Targets 2011;10(1):64–74.CrossRef
24.
Lotto V, Choi SW, Friso S. Vitamin B6: a challenging link between nutrition and inflammation in CVD. Br J Nutr 2011;106(2):183–195.PubMedCrossRef
25.
Segal R, Baumoehl Y, Elkayam O, Levartovsky D, Litinsky I, Paran D, Wigler I, Habot B, Leibovitz A, Sela BA, Caspi D. Anemia, serum vitamin B12, and folic acid in patients with rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus. Rheumatol Int 2004;24(1):14–19.PubMedCrossRef
26.
Naveh Y, Schapira D, Ravel Y, Geller E, Scharf Y. Zinc metabolism in rheumatoid arthritis: plasma and urinary zinc and relationship to disease activity. J Rheumatol 1997;24(4):643–646.PubMed
27.
Ernst B, Thurnheer M, Schmid SM, Schultes B. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes Surg 2009;19(1):66–73.PubMedCrossRef
28.
Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition 2009;25(11–12):1150–1156.PubMedCrossRef
29.
Schweiger C, Weiss R, Berry E, Keidar A. Nutritional deficiencies in bariatric surgery candidates. Obes Surg 2010;20(2):193–197.PubMedCrossRef
30.
Moizé VDR, Torres F, de Osaba JM, Vidal J. Nutritional intake and prevalence of nutritional deficiencies prior to surgery in a Spanish morbidly obese population. Obes Surg 2011;21(9):1382–1388.PubMedCrossRef
31.
de Luis DA, Pacheco D, Izaola O, Terroba MC, Cuellar L, Cabezas G. Micronutrient status in morbidly obese women before bariatric surgery. Surg Obes Relat Dis 2013;9(2):323–327.PubMedCrossRef
32.
Senapati A, Slavin BM, Thompson RP. Zinc depletion and complications of surgery. Clin Nutr 1990;9(6):341–346.PubMedCrossRef
33.
Senapati A, Thompson RP. Zinc deficiency and the prolonged accumulation of zinc in wounds. Br J Surg 1985;72(7):583–584.PubMedCrossRef
34.
Lansdown AB, Mirastschijski U, Stubbs N, Scanlon E, Agren MS. Zinc in wound healing: theoretical, experimental, and clinical aspects. Wound Repair Regen 2007;15(1):2–16.PubMedCrossRef
35.
Oberleas D, Seymour JK, Lenaghan R, Hovanesian J, Wilson RF, Prasad AS. Effect of zinc deficiency on wound-healing in rats. Am J Surg 1971;121(5):566–588.PubMedCrossRef
36.
37.
Shea-Budgell M, Dojka M, Nimmo M, Lee D, Xu Z. Marginal zinc deficiency increased the susceptibility to acute lipopolysaccharide-induced liver injury in rats. Exp Biol Med (Maywood) 2006;231(5):553–558.
38.
Knoell DL, Julian MW, Bao S, Besecker B, Macre JE, Leikauf GD, DiSilvestro RA, Crouser ED. Zinc deficiency increases organ damage and mortality in a murine model of polymicrobial sepsis. Crit Care Med 2009;37(4):1380–1388.PubMedCrossRefPubMedCentral
39.
van Rij AM, Hall MT, Bray JT, Pories WJ. Zinc as an integral component of the metabolic response to trauma. Surg Gynecol Obstet 1981;153(5):677–682.PubMed
40.
Ventral Hernia Working Group, Breuing K, Butler CE, Ferzoco S, Franz M, Hultman CS, Kilbridge JF, Rosen M, Silverman RP, Vargo D. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010;148(3):544–558.CrossRef
41.
Kanters AE, Krpata DM, Blatnik JA, Novitsky YM, Rosen MJ. Modified hernia grading scale to stratify surgical site occurrence after open ventral hernia repairs. J Am Coll Surg Dec 2012;215(6):787–793.CrossRef
42.
Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RK, Simons MP, Smietański M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A. Classification of primary and incisional abdominal wall hernias. Hernia 2009;13(4):407–414.PubMedCrossRefPubMedCentral
43.
Fawaz F. Zinc deficiency in surgical patients: a clinical study. JPEN J Parenter Enteral Nutr 1985;9(3):364–369.PubMedCrossRef
44.
Hotz C, Peerson JM, Brown KH. Suggested lower cutoffs of serum zinc concentrations for assessing zinc status: reanalysis of the second National Health and Nutrition Examination Survey data (1976–1980). Am J Clin Nutr Oct 2003;78(4):756–764.
45.
McLoughlin IJ, Hodge JS. Zinc in depressive disorder. Acta Psychiatr Scand Dec 1990;82(6):451–453.CrossRef
46.
Pepersack T, Rotsaert P, Benoit F, Willems D, Fuss M, Bourdoux P, Duchateau J. Prevalence of zinc deficiency and its clinical relevance among hospitalised elderly. Arch Gerontol Geriatr 2001;33(3):243–253.PubMedCrossRef
47.
Zorrilla P, Gomez LA, Salido JA, Silva A, Lopez-Alonso A. Low serum zinc level as a predictive factor of delayed wound healing in total hip replacement. Wound Repair Regen 2006;14(2):119–122.PubMedCrossRef
48.
Foote JW, Delves HT. Albumin bound and alpha 2-macroglobulin bound zinc concentrations in the sera of healthy adults. J Clin Pathol Sep 1984;37(9):1050–1054.CrossRef
49.
Viktorínová A, Toserová E, Krizko M, Duracková Z. Altered metabolism of copper, zinc, and magnesium is associated with increased levels of glycated hemoglobin in patients with diabetes mellitus. Metabolism 2009;58(10):1477–1482.PubMedCrossRef
50.
Ruiz-Tovar J, Oller I, Galindo I, Llavero C, Arroyo A, Calero A, Diez M, Zubiaga L, Calpena R. Change in levels of C-reactive protein (CRP) and serum cortisol in morbidly obese patients after laparoscopic sleeve gastrectomy. Obes Surg 2013;23(6):764–769.PubMedCrossRef
51.
Gong K, Gagner M, Pomp A, Almahmeed T, Bardaro SJ. Micronutrient deficiencies after laparoscopic gastric bypass: recommendations. Obes Surg 2008;18(9):1062–1066.PubMedCrossRef
52.
Salle A, Demarsy D, Poirier AL, Lelièvre B, Topart P, Guilloteau G, Bécouarn G, Rohmer V. Zinc deficiency: a frequent and underestimated complication after bariatric surgery. Obes Surg 2010;20(12):1660–1670.PubMedCrossRef
53.
54.
Rojas P, Carrasco F, Codoceo J, Inostroza J, Basfifer K, Papapietro K, Csendes A, Rojas J, Pizarro F, Olivares M, Ruz M. Trace element status and inflammation parameters after 6 months of Roux-en-Y gastric bypass. Obes Surg 2011;21(5):561–568.PubMedCrossRef
55.
Ozdemir S, Ozis ES, Gulpinar K, Aydin SM, Eren AA, Demirtas S, Korkmaz A. The value of copper and zinc levels in hernia formation. Eur J Clin Invest 2011;41(3):285–290.PubMedCrossRef
56.
Marker T, Sell H, Zillessen P, Glöde A, Kriebel J, Ouwens DM, Pattyn P, Ruige J, Famulla S, Roden M, Eckel J, Habich C. Heat shock protein 60 as a mediator of adipose tissue inflammation and insulin resistance. Diabetes 2012;61(3):615–625.PubMedCrossRefPubMedCentral
57.
Madsen C, Nafstad P, Eikvar L, Schwarze PE, Ronningen KS, Haaheim LL. Association between tobacco smoke exposure and levels of C-reactive protein in the Oslo II Study. Eur J Epidemiol 2007;22(5):311–317.PubMedCrossRef
58.
Oliveira A, Rodriguez-Artalejo F, Lopes C. Alcohol intake and systemic markers of inflammation—shape of the association according to sex and body mass index. Alcohol Alcohol 2010;45(2):119–125.PubMedCrossRef
59.
Ford DE, Erlinger TP. Depression and C-reactive protein in US adults: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 2004;164(9):1010–1014.PubMedCrossRef
60.
Ma Y, Chiriboga DE, Pagoto SL, Rosal MC, Li W, Merriam PA, Hébert JR, Whited MC, Ockene IS. Association between depression and C-reactive protein. Cardiol Res Pract 2010;2011:286509.PubMedPubMedCentral
61.
Ford ES. Asthma, body mass index, and C-reactive protein among US adults. J Asthma 2003;40(7):733–739.PubMedCrossRef
62.
de Torres JP, Cordoba-Lanus E, Lopez-Aguilar C, Muros de Fuentes M, Montejo de Garcini A, Aguirre-Jaime A, Celli BR, Casanova C. C-reactive protein levels and clinically important predictive outcomes in stable COPD patients. Eur Respir J 2006;27(5):902–907.PubMed
63.
Stuveling EM, Hillege HL, Bakker SJ, Gans RO, De Jong PE, De Zeeuw D. C-reactive protein is associated with renal function abnormalities in a non-diabetic population. Kidney Int 2003;63(2):654–661.PubMedCrossRef
64.
Ackland GL, Scollay JM, Parks RW, de Beaux I, Mythen MG. Pre-operative high sensitivity C-reactive protein and postoperative outcome in patients undergoing elective orthopaedic surgery. Anaesthesia 2007;62(9):888–894.PubMedCrossRef
65.
Allin KH, Nordestgaard BG. Elevated C-reactive protein in the diagnosis, prognosis, and cause of cancer. Crit Rev Clin Lab Sci 2011;48(4):155–170.PubMedCrossRef
66.
Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 2004;59(7):574–580.PubMedCrossRefPubMedCentral
67.
Padayachee L, Rodseth RN, Biccard BM. A meta-analysis of the utility of C-reactive protein in predicting early, intermediate-term and long term mortality and major adverse cardiac events in vascular surgical patients. Anaesthesia 2009;64(4):416–424.PubMedCrossRef
68.
Pine JK, Fusai KG, Young R, Sharma D, Davidson BR, Menon KV, Rahman SH. Serum C-reactive protein concentration and the prognosis of ductal adenocarcinoma of the head of pancreas. Eur J Surg Oncol 2009;35(6):605–610.PubMedCrossRef
69.
Saito K, Kihara K. C-reactive protein as a biomarker for urological cancers. Nat Rev Urol 2011;8(12):659–666.PubMed
70.
Sieghart W, Pinter M, Hucke F, Graziadei I, Schöniger-Hekele M, Müller C, Vogel W, Trauner M, Peck-Radosavljevic M. Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma. Hepatology 2013;57(6):2224–34.PubMedCrossRef
71.
Steinberg DI. Novel risk markers improved Framingham Risk Score cardiovascular event prediction in intermediate-risk adults. Ann Intern Med 2012;157(12):JC6–JC13.PubMedCrossRef
72.
Vallianou NG, Evangelopoulos AA, Panagiotakos DB, Georgiou AT, Zacharias GA, Vogiatzakis ED, Avgerinos PC. Associations of acute-phase reactants with metabolic syndrome in middle-aged overweight or obese people. Med Sci Monit 2010;16(2):CR56–60.PubMed
73.
Milanino R, Frigo A, Bambara LM, Marrella M, Moretti U, Pasqualicchio M, Biasi D, Gasperini R, Mainenti L, Velo GP. Copper and zinc status in rheumatoid arthritis: studies of plasma, erythrocytes, and urine, and their relationship to disease activity markers and pharmacological treatment. Clin Exp Rheumatol 1993;11(3):271–281.PubMed
74.
Afridi HI, Kazi TG, Kazi N, Shah F. Evaluation of status of zinc, copper, and iron levels in biological samples of normal and arthritis patients in age groups 46–60 and 61–75 years. Clin Lab 2012;58(7–8):705–717.PubMed
75.
Tubek S. Role of zinc in regulation of arterial blood pressure and in the etiopathogenesis of arterial hypertension. Biol Trace Elem Res 2007;117(1–3):39–51.PubMedCrossRef
76.
Afridi HI, Kazi TG, Kazi NG, Shah F. Evaluation of cadmium, lead, nickel and zinc status in biological samples of smokers and nonsmokers hypertensive patients. J Hum Hypertens 2010;24(1):34–43.PubMedCrossRefPubMedCentral
77.
78.
Swardfager W, Herrmann N, Mazereeuw G, Goldberger K, Harimoto T, Lanctot KL. Zinc in depression: a meta-analysis. Biol Psychiatry 2013.
79.
Roozbeh J, Sharifian M, Ghanizadeh A, Sahraian A, Sagheb MM, Shabani S, Hamidian Jahromi A, Kashfi M, Afshariani R. Association of zinc deficiency and depression in the patients with end-stage renal disease on hemodialysis. J Ren Nutr Mar 2011;21(2):184–187.CrossRef
80.
Piechota W, Dobrucki T, Symonowicz N, Wadowska E, Murkowska E. Zinc in patients with chronic renal failure. Int Urol Nephrol 1983;15(4):377–382.PubMedCrossRef
81.
Lindeman RD, Baxter DJ, Yunice AA, Kraikitpanitch S. Serum concentrations and urinary excretions of zinc in cirrhosis, nephrotic syndrome and renal insufficiency. Am J Med Sci 1978;275(1):17–31.PubMedCrossRef
82.
Ennes Dourado Ferro F, de Sousa Lima VB, Mello Soares NR, Franciscato Cozzolino SM, do Nascimento Marreiro D. Biomarkers of metabolic syndrome and its relationship with the zinc nutritional status in obese women. Nutr Hosp. 2011;26(3):650–654.PubMed
83.
Arnaud J, de Lorgeril M, Akbaraly T, Salen P, Arnout J, Cappuccio FP, van Dongen MC, Donati MB, Krogh V, Siani A, Iacoviello L; European Collaborative Group of the IMMIDIET Project. Gender differences in copper, zinc and selenium status in diabetic-free metabolic syndrome European population — the IMMIDIET study. Nutr Metab Cardiovasc Dis 2012;22(6):517–524.PubMedCrossRef
84.
Garcia OP, Ronquillo D, Caamano Mdel C, Camacho M, Long KZ, Rosado JL. Zinc, vitamin A, and vitamin C status are associated with leptin concentrations and obesity in Mexican women: results from a cross-sectional study. Nutr Metab (Lond) 2012;9(1):59.CrossRef
85.
Henzel JH, DeWeese MS, Pories WJ. Significance of magnesium and zinc metabolism in the surgical patient: II. Zinc. Arch Surg 1967;95(6):991–999.CrossRef
86.
Henzel JH, DeWeese MS, Lichti EL. Zinc concentrations within healing wounds. Significance of postoperative zincuria on availability and requirements during tissue repair. Arch Surg 1970;100(4):349–357.
87.
Besecker BY, Exline MC, Hollyfield J, Phillips G, Disilvestro RA, Wewers MD, Knoell DL. A comparison of zinc metabolism, inflammation, and disease severity in critically ill infected and noninfected adults early after intensive care unit admission. Am J Clin Nutr Jun 2011;93(6):1356–1364.CrossRef
88.
89.
Myers MA, Fleck A, Sampson B, Colley CM, Bent J, Hall G. Early plasma protein and mineral changes after surgery: a two stage process. J Clin Pathol 1984;37(8):862–866.PubMedCrossRefPubMedCentral
90.
Srinivas U, Ohlsson T, Hallstadius L, Hansson L, Abdulla M, Strand SE, Jeppsson B. Organ sequestration of 65Zn during experimental sepsis. Clin Nutr Oct 1989;8(5):263–267.CrossRef
91.
Boosalis MG, Solem LD, Cerra FB, Konstantinides F, Ahrenholz DH, McCall JT, McClain CJ. Increased urinary zinc excretion after thermal injury. J Lab Clin Med 1991;118(6):538–545.PubMed
92.
de Haan KE, de Goeij JJ, van den Hamer CJ, Boxma H, de Groot CJ. Changes in zinc metabolism after burns: observations, explanations, clinical implications. J Trace Elem Electrolytes Health Dis 1992;6(3):195–201.PubMed
93.
Berger MM. Antioxidant micronutrients in major trauma and burns: evidence and practice. Nutr Clin Pract 2006;21(5):438–449.PubMedCrossRef
94.
Collins N, Friedrich L. Multivitamin supplements—magic bullet or waste of money? Ostomy Wound Manage 2010;56(5):18–24.PubMed
95.
Marik PE, Zaloga GP. Immunonutrition in high-risk surgical patients: a systematic review and analysis of the literature. JPEN J Parenter Enteral Nutr 2010;34(4):378–386.PubMedCrossRef
96.
97.
McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol 2006;101(4):812–822.PubMedCrossRef
98.
Mekkes MC, Weenen TC, Brummer RJ, Claassen E. The development of probiotic treatment in obesity: a review. Benef Microbes 2013:1–10. doi:10.​3920/​BM2012.​0069.
Metadata
Title
Prevalence of Systemic Inflammation and Micronutrient Imbalance in Patients with Complex Abdominal Hernias
Authors
Abby K. Geletzke
John M. Rinaldi
Brett E. Phillips
Sarah B. Mobley
Jamie Miller
Thomas Dykes
Christopher Hollenbeak
Shannon L. Kelleher
David I. Soybel
Publication date
01-04-2014
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 4/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-013-2431-y

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