Use of polypropylene mesh in contaminated and dirty strangulated hernias: short-term results

Pandey, Himanshu; Thakur, Dileep Singh; Somashekar, Uday; Kothari, Reena; Agarwal, Pawan; Sharma, Dhananjaya

doi:10.1007/s10029-018-1811-3

Cited by 40 publications

(31 citation statements)

References 40 publications

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“…However, depending on the localization and fixation of the previous mesh, the problem could range from an asymptomatic patient to a patient with a solid mass and pain. Regarding mesh removal, most of the studies concern the removal of infected mesh [7][8][9][10][11][12]. Although some studies concern laparoscopic repair of recurrent ventral hernias, there is still a lack of data about mesh removal during the procedure [13].…”

Section: Discussionmentioning

confidence: 99%

“…The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome foreign body has not been comprehensively studied in the literature. Considering the removal of mesh, most of the studies concern mesh infections [ [7][8][9][10][11][12]. Data on the efficacy of mesh removal during laparoscopic repair remain missing.…”

Section: Introductionmentioning

confidence: 99%

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The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

Sıkar

Çetin

2019

Videosurgery and Other Miniinvasive Techniques

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IntroductionRecurrent hernias can be treated by laparoscopy without the need for mesh removal. However, shrinkage of the mesh following recurrence affects most of the patients, and leaving a partially floating and rigid foreign body could be discussed.AimTo compare the outcomes of patients regarding the removal of previous mesh during laparoscopic repair of recurrent abdominal wall hernias.Material and methodsPatients who underwent laparoscopic repair for recurrent ventral hernias between August 2012 and March 2015 were included in the study. The patients with complete removal of the mesh were included in the MR group and the patients with partial removal or without removal of the previous mesh were included in the non-MR group. Patient characteristics and demographics, previous hernia repair, defect size, mesh size, operative time, mean hospital stay, complications, recurrences, numeric pain rating scale (NRS), early termination of analgesics and prolonged use of analgesics were compared.ResultsA total of 112 patients with a mean age of 53.2 and mean body mass index of 31.1 kg/m2 underwent laparoscopic repair. There were 47 patients in the MR group and 54 patients in the non-MR group. Operative time was shorter in the non-MR group (p < 0.05), whereas symptomatic seroma and NRS scores on postoperative day 10 and at the 6th week were higher in comparison with the MR group (p < 0.05).ConclusionsMesh removal during laparoscopic repair of recurrent ventral hernias has an association with the reduction of pain and symptomatic seroma. However, further prospective comparative studies are required to verify this view.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

Sıkar

Çetin

2019

Videosurgery and Other Miniinvasive Techniques

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“…However, traditional tissue herniorrhaphy resulted in a high recurrence rate, and the requirement of additional repairing operation undoubtedly increased medical costs and frustrated patients. Recent studies have shown that it is safe and effective to use a prosthetic mesh in the emergency repair of incarcerated or strangulated hernia [ 1 , 10 , 28 , 29 ]. Besides, it is recognized that intestinal necrosis and enterectomy are not absolute contraindications of performing a mesh repair [ 1 , 2 , 5 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors of postoperative complications after emergency repair of incarcerated groin hernia for adult patients: a retrospective cohort study

Dai

Chen

Zuo

et al. 2018

Hernia

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Purpose This study aimed to explore risk factors of postoperative complications for adult patients with incarcerated groin hernia (IGH). Methods From January 2010 to December 2017, consecutive patients undergoing emergency hernia repair for IGH in our center were retrospectively reviewed. Postoperative complications, such as surgical site infection, seroma, hernia recurrence and mortality, were investigated, with risk factors for such complications analyzed using univariate and multivariate regressions. Results Sixty-four patients were included, with 51 males and 13 females (mean age 65.1, range 25–98 years). Ten patients (15.6%) underwent resection of necrotic bowel and anastomosis. 43 patients (67.2%) received open tension-free herniorrhaphy with polypropylene mesh, whereas the rest (32.8%) received herniorrhaphy without mesh. The overall postoperative complication rate was 40.6% (26/64), with an incisional complication rate of 31.2% (20/64) and an infection rate of 6.2% (4/64). At a median follow-up of 32 months, hernia recurrence and mortality were recorded in five cases each (7.8%). Mesh repair was associated with decreased recurrence rate compared with non-mesh repair (2.3% vs. 19.0%, p = 0.019). Diabetes mellitus (OR 8.611, 95%CI 1.292–57.405; p = 0.026) was an independent risk factor of postoperative complications, together with chronic obstructive pulmonary disease (COPD; OR 14.365, 95%CI 1.652–127.767, p = 0.016), intestinal necrosis (OR 14.260, 95%CI 1.079–188.460, p = 0.044), and general anesthesia (OR 14.543, 95%CI 1.682–125.711, p = 0.015) as risk for incisional complications after surgery. Conclusions Diabetes mellitus was an independent risk factor of postoperative complications for IGH, along with COPD, intestinal necrosis and general anesthesia associated with incisional complications. The use of polypropylene mesh did not increase infection or recurrence rate in this cohort.

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“…The nonabsorbable synthetic large-pore mesh does not promote infection because pores >70 μm allow the white blood cells and macrophages to reach the bacteria, which are often <1 μm. 9 …”

Section: Discussionmentioning

confidence: 99%

The Internal Oblique Muscle Flap with Synthetic Mesh Reinforcement for a Large, Contaminated Abdominal Wall Defect

Watanabe

Sakuma

Kono

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Summary: We report a case of a large mediocaudal abdominal defect in contaminated circumstances with no residual rectus abdominis muscle that was reconstructed using an internal oblique muscle flap with large-pore polypropylene mesh reinforcement. The internal oblique muscle flap can reconstruct the lower abdominal midline without leaving any additional conspicuous scar. Previous studies showed that large-pore polypropylene mesh in contaminated wounds has a minimal difference in terms of infection rate, and less frequent occurrence of hernia, compared even with biological meshes. We believe that this method could be a strong and cosmetically satisfying option for large mediocaudal abdominal wall reconstruction.

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Use of polypropylene mesh in contaminated and dirty strangulated hernias: short-term results

Abstract: The use of polypropylene mesh for contaminated and dirty strangulated hernias is effective and safe, with acceptable morbidity and good short-term results.

Cited by 40 publications

References 40 publications

The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

Risk factors of postoperative complications after emergency repair of incarcerated groin hernia for adult patients: a retrospective cohort study

The Internal Oblique Muscle Flap with Synthetic Mesh Reinforcement for a Large, Contaminated Abdominal Wall Defect

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