Cytokine Response to Abdominal Wall Reconstruction

This is a prospective, observational translational study of patients undergoing major abdominal wall reconstruction with primary fascial closure. The project integrates perioperative cytokine profiling, direct measurement of intra-abdominal pressure, and detailed clinical outcomes to define the biologic and physiologic consequences of high-tension closure. The study includes three cohorts: 1) Healthy controls (N=5), 2) High-tension fascial closure AWR patients (N=10), 3) Low-tension fascial closure AWR patients (N=10). Fascial closure tension will not be altered for the purpose of the study and will be determined by the operating surgeon as part of routine clinical decision-making.

Inclusion Criteria: Surgical Participants * Adults aged 18 years or older * Scheduled to undergo open retromuscular ventral hernia repair * Able to provide written informed consent Healthy Control Participants * Adults aged 18 years or older * No known inflammatory, autoimmune, or immunologic disease * Able to provide written informed consent Exclusion Criteria: * Emergent or urgent cases * Pregnancy * Chronic systemic steroid use or immunosuppressive therapy * Active infection at the time of enrollment * Known autoimmune or inflammatory disease * End-stage organ failure * Abdominal surgery within the preceding 60 days