CLINICAL OUTCOME OF USE OF MESH IN ACUTE HERNIA | ||
| The Egyptian Journal of Surgery | ||
| Volume 32, Issue 1, January 2013, Pages 37-41 PDF (540.61 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2013.366755 | ||
| Authors | ||
| Khaled Ahmed* ; Abd Al-Lateif Ahmed; Mohamed Abdel Aziz; Taha Bahgat | ||
| Department of General Surgery, Faculty of Medicine, Al-Azhar University, Egypt | ||
| Abstract | ||
| Background: Mesh repair is now the gold standard technique of repair on incisional hernias. Infection of the mesh is a challenging complication of this type of repair. The risk of mesh infection has been shown to be greater in case of complicated hernia. Incarceration of inguinal, umbilical and cicatricial hernias is a frequent problem. However, little is known about the relationship between the use of mesh and outcome after surgery. The goal of this study was to describe the relationship between the use of mesh in incarcerated hernia and the clinical outcome. Patients and Methods: Correspondence, operation reports and patient files between January 2010 and December 2012 of patients presented at two hospitals in sohag and Assuit were searched for cases of: incarceration, strangulation and hernia. The patient characteristics, clinical presentation, pre-operative findings and clinical course were scored and analysed. Results: A total of 183 patients could be identified: 68 inguinal, 48 umbilical, 35 incisional, 13 epigastric, 13 femoral, 3 trocar and 3 Spigelian hernias. In the statistical analysis, epigastric, femoral, trocar and Spigelian hernias were pooled, due to their small group sizes. One patient was excluded from the analysis because the hernia was not corrected during operation. In total, 90 hernias were repaired using mesh versus 92 primary suture repairs. 22 wound infections were registered (7%). One mesh was removed during a reintervention for anastomotic leakage, although no signs of wound infection were present. Nine patients died, none of them due to woundrelated problems one cardiovascular, one ruptured aneurysm, three pulmonary complications, two anastomotic leakage, two sepsis of unknown origin) Univariate analysis showed that female patients (P = 0.007), adipose patients (P = 0.016), patients with an umbilical hernia (P = 0.01) and patients who underwent a bowel resection (P = 0.015) had a significantly higher rate of wound infections. The type of repair (e.g. primary suture or mesh), use of antibiotic prophylaxis, gender, ASA (American Society of Anesthesiologists) class and age showed no significant relation with post-operative wound infection. After logistic regression analysis, only bowel resection (P = 0.020) showed a significant relation with post-operative wound infection. Conclusions: Wound infection rates are high after the correction of acute hernia, but clinical consequences are relatively low. Mesh correction of an acute hernia seems to be safe and should be considered in every incarcerated hernia. | ||
| Keywords | ||
| Hernia; Acute; Abdominal | ||
|
Statistics Article View: 48 PDF Download: 24 |
||
