Mesh sutured repairs of contaminated incisional hernias

Dumanian, Gregory A.; Lanier, Steven T.; Souza, Jason M.; Young, Mimi Wu; Mlodinow, Alexei S.; Boller, Anne Marie; Mueller, Kyle H.; Halverson, Amy L.; McGee, Michael F.; Stulberg, Jonah J.

doi:10.1016/j.amjsurg.2017.10.025

Cited by 20 publications

(28 citation statements)

References 22 publications

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“…Forty-eight patients with some form of minimal potential wound contamination during repair of incisional hernias averaging 10 cm in width were closed with this "mesh sutured repair." 43 The recurrence rate of hernia formation was 13% with a mean followup of 12 months. Therefore, mesh sutured repairs may represent a new era of high surface area/low filament size closures that distribute forces and lay down a magnified foreign-body response at the site of suture closure.…”

Section: Closure Of the Abdominal Wall With Mesh-derived Suturesmentioning

confidence: 94%

Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias

Harris

Hope

Adrales

et al. 2018

Surgery

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Incisional hernia is a frequent complication of midline laparotomy and enterostomal creation and is associated with high morbidity, decreased quality of life, and high costs. The International Symposium on Incisional Hernia Prevention was held October 19-20, 2017, at the InterContinental Hotel in San Francisco, CA, hosted by the Department of Surgery, University of California, San Francisco. One hundred and three attendees included general and plastic surgeons from 9 countries, including principal participants for several of the seminal studies in the field. Over the course of the 2-day meeting, there were 38 oral presentations, 3 keynote lectures, and 2 panel discussions. The Symposium was a combination of new information but also a comprehensive review of the existing data so as to assess the current state of the field and to set the stage for future research. Further, the Symposium sought to increase awareness and thus emphasize the importance of preventing the formation of incisional and enterostomal hernias.

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Section: Closure Of the Abdominal Wall With Mesh-derived Suturesmentioning

confidence: 94%

Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias

Harris

Hope

Adrales

et al. 2018

Surgery

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“…The efficacy of the mesh strips is most dramatically demonstrated in the 48 contaminated repairs CDC grades 2 to 4 with average hernia widths of 10.5 cm preoperatively by computed tomography scan [38]. Mesh sutured repairs obviate the need to open tissue planes to place a large planar mesh.…”

Section: Mesh Sutured Repairsmentioning

confidence: 99%

Fascial Closure

Dumanian

Moradian

2020

Advances in Surgery

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The ultimate tensile strength of newly apposed tissue is the sum of the strength of the physical construct holding the tissues and the strength of biologic healing. For successful laparotomy closure or incisional hernia repair, the total strength of the repair must remain greater than the opposing forces applied at the suture/ tissue interface. Given limited progress over recent years, recent research focuses on an improved distribution of forces at the suture/tissue interface that can limit tissue tearing, suture pull-through, and incisional hernia formation.

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“…Methods described for this study include the use of bone anchors 43 , 44 , 48 , 49 and direct suture fixation. 50 The senior author has developed a method of hernia repair using 2-cm strips of macroporous polypropylene mesh 51 , 52 that are used as sutures. A strip of mesh has the advantage of a larger surface area and, thus, a greater force distribution across the closure when compared with a single strand of suture.…”

Section: Introductionmentioning

confidence: 99%

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

Kearney

Dumanian

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically difficult aspect of these repairs is fixating the abdominal wall to the iliac crest. The senior author has developed a method of repair using 2-cm strips of mesh. In this article, we present a description of 4 patients treated with this technique. Methods: We included 4 adult patients who underwent traumatic flank hernia repairs by the senior author. We excluded incisional hernias and patients who received a planar sheet of mesh. Demographics and outcomes collected included length of stay, follow-up time, and complications. Results: The average age was 38.5 years. Three hernias were due to motor vehicle collision injuries, and 1 was a crush injury at work. No planar meshes or bone anchors were used. No patients required component separation. There were no instances of surgical site infection, hematoma, or wound breakdown. All repairs were intact at the time of last follow-up (average, 24.3 months; range, 4–48.7 months). Conclusions: Traumatic flank hernias are rare injuries that can be difficult to address. Here, we describe a technique of primary repair with mesh strips that distribute the forces of repair across a greater surface area than can be achieved with sutures. Placing drill holes through the iliac crest avoids the cost and complexity of suture anchors.

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Mesh sutured repairs of contaminated incisional hernias

Abstract: Mesh sutured closure represents a simplified and effective surgical strategy for contaminated midline incisional hernia repair.

Cited by 20 publications

References 22 publications

Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias

Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias

Fascial Closure

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

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