Mesh sutured repairs of contaminated incisional hernias

Am J Surg. 2018 Aug;216(2):267-273. doi: 10.1016/j.amjsurg.2017.10.025. Epub 2017 Oct 25.

Abstract

Background: We sought to evaluate the results of a new mesh sutured repair technique for closure of contaminated incisional hernias.

Methods: 48 patients with contaminated hernias 5 cm wide or greater by CT scan were closed with mesh sutures. Surgical site occurrence, infections, and hernia recurrence were compared to similar patient series reported in the literature.

Results: Of the 48 patients, 20 had clean-contaminated wounds, 16 had contaminated wounds, and 12 were infected. 69% of the patients underwent an anterior perforator sparing components release for hernias that averaged 10.5 cm transversely (range 5 cm-25 cm). SSO occurred in 27% of patients while SSI was 19%. There were no fistulas or delayed suture sinuses. With a mean follow-up of almost 12 months, 3 midline hernias recurred (6%). In these same patients, three parastomal hernias repaired with mesh sutures failed out of 4 attempted for a total failure rate of 13%.

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

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Herniorrhaphy / methods*
  • Humans
  • Incisional Hernia / diagnosis
  • Incisional Hernia / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Recurrence
  • Surgical Mesh*
  • Suture Techniques / instrumentation*
  • Sutures*
  • Tomography, X-Ray Computed
  • Young Adult