Polypropylene Mesh for Recurrent Incisional Hernia: Different Operative Techniques
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 6, Issue 4
Abstract
Aims: To locate the plane of mesh insertion whether it is onlay, inlay, sublay, or underlay. Design: Prospective study Place and Duration: Done at Bani suef hospital between May 2011 till May 2012 with follow till May 2014. Methodology: Twenty two patients, six were males sixteen were females with recurrent incisional hernias were included in the study with a mean age ± SD of 44 years ± 11.87, there were 14 patients presented after the first recurrence (Groups 1, 2), 7 patients after the second recurrence (Groups 3, 4) and only one for the third recurrence. There were no significant difference between patients presented by 1st and 2nd recurrence concerning the age, sex and level of hernia. To all patients a polypropylene mesh was applied, 12 onlay, 2 inlay, 5 sublay and 3 underlay. Results: There were two serosal lesions and only one perforation. There were 4(18%) patients with seroma, 1 (4.5%) with haematoma, 4 (18%) with infection, 3 (13.6%) with DVT, 1 (4.5%) with non fatal PE, and 1 (4.5%) respiratory failure. The highest incidence of complications were in the onlay repair, the lowest in the underlay repair. The patients were followed for two year, there were 6 recurrence (27.2%), most of them were in the onlay repair with the highest incidence in the inlay repair. The incidence of recurrence in the onlay to inlay was statistically non significant (P<0.5), the onlay to the sublay was significant (P<0.05) and the onlay to the underlay was highly significant (P<0.02). Conclusion: It is to be concluded that when a patient with recurrent incisional hernia is in need for repair, it is better to avoid inlay technique, not to do the underlay and the onlay techniques, and recommended to do the sublay approach.
Authors and Affiliations
Mohamed Salah Eldin Abdel Hamid, Ahmed Mohmed Sadat, Tamer Mohmed Nabil, Mohmed Salah Abdelbasat, Amr Mohmmed Aly, Hesham Ahmed Abdel Wahab Nafady, Mohmed Hassan Abdelmoal, Ahmed Zaki Gharib, Adel Morad Abdellah, Assad Fauroz Salama, Mahmoud Ahmed Nigada
Keywords
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- EP ID EP347086
- DOI 10.9734/BJMMR/2015/14911
- Views 83
- Downloads 0
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