Background: wound infections that develop after a hernia repair can be linked to systemic issues, mesh infections, and hernia recurrence. Objective: To assess outcomes of incisional surgical site infection without mesh to prevent incisional hernia. Methodology: This was a Prospective interventional study which was conducted in Department of Colorectal Surgery Bangabandhu Sheikh Mujib Medical University fromApril, 2019- September, 2020 using a semi-structured questionnaire through face to face interview. Data were analysed using a computer programme SPSS 24.0 version. Result: the mean age of the respondents was 56.73±7.72 years. About 80% were male. The mean BMI was 25±5.5. About 16.7% had Parastomal Hernia and 8.3% had midline Incisional Hernia. 3 patients at 4th week and 1 patient at 3rd month had surgical site infection. Conclusion: Hernia operations are traditionally regarded as clean operations due to the anticipated, low likelihood of infection at the site of surgical intervention (SSI).
Background: Systemic problems, mesh infections, and hernia recurrence have all been related to wound infections that appear after a hernia repair. Objective: To assess the risks factor after surgical site infection with and without mesh incisional hernia. Methodology: The study was a Prospective interventional study which was conducted in Department of Colorectal Surgery Bangabandhu Sheikh Mujib Medical University from April, 2019- September, 2020 using a semi-structured questionnaire through face to face interview. Data were analysed using a computer programme SPSS 24.0 version. Result: The mean age of no mesh group was 55.83±8.42 years while the mesh group was 53.29±9.81 years. A majority of male patients in both, no mesh (70.8%) and mesh (66.7%), groups. The mean BMI of no mesh group was 25.13±5.49 while the mesh group was 26.98±4.46. 3 patients at 4th week and 1 patient at 3rd month had infection in no mesh group. And, 7 patients at 4th week, 2 at 3rd month and 1 patient at 6th month had infection in the mesh group. There was no difference statistically between no mesh and mesh groups (p=0.094, p=0.472 and p=0.280 at 4th week, 3rd month and 6th month, respectively. Conclusion: Obesity, tobacco use, and diabetes mellitus are the three main patient comorbidities that can be modified and are substantially linked to postoperative surgical site infection in hernia surgery. Weight reduction, quitting smoking, and diabetes management are all part of preoperative optimization.
Background: Stomal site incisional hernia is a common complication following ostomy closure. Prophylactic mesh reinforcement of the fascial defect is typically not considered due to the contaminated nature of the case. The effectiveness of prophylactic mesh placement at the time of stoma closure is unknown because of fear of mesh infection and subsequent wound complications. Purpose: To compare the results obtained by placing synthetic mesh in the stoma site during closure with conventional technique without mesh to prevent incisional. Patients and Methods: Prospective interventional study had been designed to compare the outcome of permanent synthetic mesh placement at the time of ostomy closure. Total 45 patients were selected purposively who were candidates for ostomy closure and presented at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2019 to September 2020 and divided into two groups (no mesh and mesh). In the mesh group, permanent synthetic mesh (ProleneTM – Polypropylene) was placed. Primary outcome, incisional stomal hernia was assessed at regular follow-up for one year along with associated morbidities. Results: The primary outcome of this study i.e. incisional hernia (stomal site) was observed among 1 (4.8%) patients at 4th week, 3 (14.3%) at 3rd month, 7 (33.3%) at 6th month and 8 (38.1%) at 12th month follow-up in no mesh group. And, only 1 patient at 6th month and 12th month follow-up had hernia in the mesh group (Figure 3). There was no difference statistically between no mesh and mesh groups at 4th week and 3rd month but significant difference found at 6th and 12th month follow-up (p=0.280, p=0.344, p=0.033 and p=0.017, respectively). Conclusion: Prophylactic placement of permanent polypropylene mesh during ostomy closure placement significantly reduced the rate of incisional hernia without any additional morbidity. Placement of mesh was found to be both safe and effective.
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