Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up

Sauerland, Stefan; Schmedt, C.‐G.; Lein, Silke; Leibl, B. J.; Bittner, R.

doi:10.1007/s00423-005-0567-2

Cited by 60 publications

(33 citation statements)

References 28 publications

(23 reference statements)

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“…The use of mesh implants in hernia surgery has become increasingly widespread, due to good postoperative results and low rates of long-term recurrence [5,18]. Polypropylene has been established as the basic synthetic material for mesh; it is a versatile thermoplastic polymer that exhibits excellent chemical resistance, low density, high tensile strength and a relatively high melting point, especially in comparison to its counterpart, polyethylene.…”

Section: Discussionmentioning

confidence: 99%

“…Millions of meshes are implanted every year, and they have unquestionably been demonstrated to ensure tension-free mechanical stability and fascial reinforcement in the repair of hernial defects of the abdominal wall, with very low recurrence rates [5]. With respect to oncogenic potential, findings are sufficient to conclude that modern mesh materials and construction are not associated with an increased risk of malignant tissue degeneration [6].…”

Section: Introductionmentioning

confidence: 99%

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Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Canuto

Saracino

Oraldi

et al. 2012

Hernia

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Purpose: Abdominal wall hernia is one of the commonest surgical disorders world-wide and there is no single gold-standard operative technique to repair it. In an effort to improve techniques and technologies to reinforce hernia repair, synthetic meshes are employed. In this study a new prosthesis (named composite) formed of two polypropylene layers, one macroporous (named mesh) and one transparent (named film) was examined to evaluate its capability to enable cell proliferation without inducing cell death. Inflammatory processes were also examined.Methods: Human fibroblasts BJ were seeded on multiwells, on which composite or film had been placed. After 7, 14 and 21 days, cell growth and viability, deposition of collagen, and release of IL-6, IL-1β and TNF-α were evaluated.Results: The "in vitro" protocol showed the composite to be colonized by human fibroblasts on the polypropylene macroporous mesh side; no cell growth occurred on the film. The slowdown of cell growth observed between 14 and 21 days was accompanied by an increase of type I collagen deposition and marked fibroblast activity. Inflammatory cytokines initially increased, followed by their reduction beginning at 14 days.Conclusions: The new prosthesis comprising two polypropylene layers of differing morphologies can be colonized by fibroblasts on the side facing the abdominal wall, whereas no cell growth occurs on the side facing the viscera. The transient inflammation, observed at early experimental times, is probably important for the healing process.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Canuto

Saracino

Oraldi

et al. 2012

Hernia

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“…Long-term studies show the necessity of using a mesh in all defects above 4 cm in diameter [10][11][12][13] . In the case series at our hospital, we used PP mesh characterized by elasticity, low price and preservation.…”

Section: Discussionmentioning

confidence: 99%

Is Repair of Incisional Hernias by Polypropylene Mesh a Safe Procedure?

Yıldırım

Engin²,

Karademir³

et al. 2010

Med Princ Pract

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Objective: The aim of our study was to evaluate the safety of the intraperitoneal mesh repair procedure and to assess the complications that develop after the procedure. Subjects and Methods: We reviewed the records of 25 patients who underwent intraperitoneal mesh repair procedures. Data on age, sex, size and cause of the hernia, postoperative mortality, and morbidity with special attention to complications were obtained from the medical records. Results: Of the 25 patients (7 males, 18 females), the original operation was cholecystectomy in 15 cases (60%), gynaecological surgery in 2, gastric surgery in 2, and umbilical hernia in 2. Incisions were midline in 20 cases (80%), transverse in 2 and laparoscopic port sites in 3 patients. The average size of the hernia was 150 cm². Local complications occurred in 4 (16%) patients. Postoperative complications included wound infection in 3 patients and haematoma in 1 patient. Postoperative hospital stay ranged from 3 to 25 days with a mean of 6 days. No recurrence developed during 28-month follow-up. Conclusion: The tension-free repair of incisional hernia with polypropylene mesh in intraperitoneal position is a safe and easy procedure with acceptable morbidity and no recurrence.

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“…Previously used open primary suture techniques had high recurrence rates and complication rates as high as 44% (14). Although many techniques are defined for the repair of incisional hernias, in open mesh repair techniques, the location where the mesh should be placed is still under debate.…”

Section: Incisional Hernia Remains a Major Problem After Laparotomymentioning

confidence: 99%

Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia

Sevinç

Okuş

et al. 2018

Turk J Surg

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Objective: Incisional hernia is a significant problem after laparotomy, and there is still no consensus on an ideal treatment method. The aim of this study was to compare the results of onlay and sublay mesh repair techniques. Material and Methods:In this randomized prospective trial, 100 patients were divided into two groups: onlay and sublay groups. Recurrences were evaluated by performing a physical examination. Results:The median follow-up was 37.1 (26.6 to 46.5) months. In the onlay group, the mean operation time was significantly shorter. However, in terms of postoperative pain and wound complications, the sublay group had significantly better results. The recurrence rates were found to be similar in both groups (6% in the onlay group and 2% in the sublay group). Conclusion:In the treatment of incisional hernia, sublay mesh repair is superior to onlay mesh repair in terms of postoperative pain and wound complications. Both techniques have similar recurrence rates. Keywords:Incisional hernia, mesh repair, onlay, sublay INTRODUCTIONIncisional hernia is a significant complication after laparotomy; its incidence ranges between 10% and 20% (1-4). This common problem can result in bowel strangulation, pain, and enterocutaneous fistula, and it affects the quality of life. The results of repair techniques vary widely. High recurrence rates have been reported for suture techniques, whereas mesh placement can reduce recurrence (5-10). In mesh repair, one of the most important problems is the placement of the mesh. Some techniques are reported to be associated with particularly high rates of some complications, such as recurrence, wound infection, and fistula (11,12). In the literature, several studies compare mesh and suture repair techniques, open and laparoscopic repair techniques, and mesh type as well as the plane in which the mesh should be placed. Currently, there is no consensus regarding the abdominal plane in which the mesh should be placed (13).The aim of this study was to compare the early and late results of onlay and sublay mesh repair techniques. , an American Society of Anesthesiologists score (ASA) of 4, or severe pulmonary or cardiac disease were not included. The remaining patients who agreed to be involved and signed the informed consent form were randomized into two groups: onlay group and sublay group. After the initial evaluation, 100 patients were included and were randomized to each group by the closed envelope method. The patients' demographic data, BMI, diameter of fascial defects, operation time (from first incision to dressing), visual analog scale (VAS) scores at the second and 24 th hours, length of hospital stay, drain takeoff time, postoperative complications, and recurrences were recorded. The fascial defect diameter was measured intraoperatively and is presented in cm 2 . All operations were performed according to the elective standard. There were no emergency operations. MATERIAL AND METHODS Operative TechniqueAll operations were performed under general anesthesia, and no antibioti...

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Primary incisional hernia repair with or without polypropylene mesh: a report on 384 patients with 5-year follow-up

Abstract: Our data confirms the long-term effectiveness of mesh repair under routine conditions. Suture repair should be restricted to small hernias in patients free of known risk factors.

Cited by 60 publications

References 28 publications

Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Is Repair of Incisional Hernias by Polypropylene Mesh a Safe Procedure?

Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia

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