The single-staged approach to the surgical management of abdominal wall hernias in contaminated fields

Abstract

This study shows that single-stage treatment of ventral hernias in contaminated fields can be accomplished with a low recurrence rate and acceptable morbidity in these extremely challenging patients.

Untitled

“…[1][2][3][4]6,19,20 Predisposing factors are age, obesity, alcoholism, smoking, multiple operations, foreign body implantation, wound infection, hematoma, technical error, and unsuitable suture material. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] In addition, medical illnesses such as chronic renal failure, liver insufficiency, infection, and pulmonary diseases are known risk factors.…”

“…[5][6][7] The effects of immunosuppression and renal transplant on wound healing have been welldocumented. [7][8][9][10][11][12][13][14][15][16][17][18] Corticosteroids play an important role in the development of incisional hernias by impeding wound healing. [8][9][10][11][12][13][14][15][16][17][18] During acute rejection, when higher doses of methylprednisolone (1 g/day) are administered, steroids have been shown to have considerable effects on the development of incisional hernias.…”

“…[7][8][9][10][11][12][13][14][15][16][17][18] Corticosteroids play an important role in the development of incisional hernias by impeding wound healing. [8][9][10][11][12][13][14][15][16][17][18] During acute rejection, when higher doses of methylprednisolone (1 g/day) are administered, steroids have been shown to have considerable effects on the development of incisional hernias. [8][9][10][11] Use of mycophenolate mofetil, tacrolimus (Astellas Pharma, Chuo-ku, Japan), and sirolimus (Pfizer, Groton, CT, USA) for immunosuppression has been shown to be significant risk factors for hernias.…”

“…[8][9][10][11][12][13][14][15][16][17][18] During acute rejection, when higher doses of methylprednisolone (1 g/day) are administered, steroids have been shown to have considerable effects on the development of incisional hernias. [8][9][10][11] Use of mycophenolate mofetil, tacrolimus (Astellas Pharma, Chuo-ku, Japan), and sirolimus (Pfizer, Groton, CT, USA) for immunosuppression has been shown to be significant risk factors for hernias. [12][13][14][15][16][17][18] Mycophenolate mofetil has been shown to have an antiproliferative effect that may interfere with the healing of the muscles and fascia.…”

“…Several studies have shown that SSI is the most important risk factor for hernia development. 1,[6][7][8][9][10][11][12] The negative effects of immunosuppressive therapy after renal transplant can further contribute to the high incidence of SSI, leading to increased incidence of incisional hernias due to disturbed and delayed wound healing.…”