Open Mesh Repair for Different Types of Ventral Hernias Is It Safe?
Abstract
Background: Mesh repair had been advocated as an alternative method of repair for different types of ventral hernias. Many complications had been recorded following such repair, like wound infection, pain, seroma, haematoma, mesh infection, local reaction, mechanical failure, recurrence, thickening of spermatic cord and testicular atrophy
Objectives: To assess the complications of open mesh repair of different types of ventral hernias and their management in Al-Kindy teaching hospital
Methods: Two hundred and forty-eight patients were included in this prospective study who was admitted to Al-Kindy teaching hospital from April 2005 to December 2008. All patients were operated upon by open mesh repair technique. Mesh were fixed to the site of the defect by onlay technique by non absorbable 2/0 suture materials. Drains were inserted when needed. Patients were followed up to 1 year at interval of 1, 3, 6 months and one year, postoperatively. The complications were recorded and treated accordingly. The data were statistically evaluated by measuring the p value
Results: Out of 248 patients, there were 190 males (76%) and 58 female (23%). The mean age incidence was 44 years (±14 SD), ranging from 22-75 years. One hundred and sixty eight patients had inguinal hernia (67%). Forty eight patients had paraumbilical (19%). Twenty eight patients had incisional (11%) and 18 patients had epigastric hernia (7%). Early complications were reported. The commonest early complications were wound infection (4%) and hematoma (0.8%). Late complications were post operative pain (3.2%) and recurrence (1.6%)
Conclusion: In spite of good results after mesh hernia repair, it was not free from complications. The use of antibiotics and suction drain can play a role in reduction of number of complications especially in paraumbilical and incisional hernia. Ultrasound is good tool for diagnosis of postoperative complications as in seroma, hematoma and abscess formation and can be an aid to the drainage.
Keywords: Polypropylene mesh repair, Hernia repair, conservative management.
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