Complications of repair of incisional hernia using polypropylene mesh

Abstract

Objective:- To find out frequency and type of complications after repair of incisional hernia using polypropylene mesh. Design:- It is a descriptive type of study. Place and duration of study:- This study was conducted in surgical Unit-I and Surgical Unit II Nishtar Hospital Multan from March 2003 to February 2005. Patients and method: After admission of the patient a detailed history, thorough physical examination was done and a proforma filled containing information about previous operation. Investigations like complete blood examination, complete Urine examination, random blood sugar level, X-ray chest, ultrasound were performed and patients put on the operation list. Polypropylene mesh placed in retromuscular plane and patients were observed for complications. Results:- Male to female ratio was 1:1.85. Age varied from 14-70 years. 32 patients (80%) were between the age of 31-60 years. 6 patients (15%) were between the age of 20-30 years 2 patients (5%) were between the age of 61-70 years. The approximate time interval between the initial operation and appearance of hernia, predominantly in all 40 patients was within first year following surgery, in fact 27 patients developed incisional hernia within first 3 months, incidence decreased gradually over subsequent years. The most common presentation was protusion of abdomen in all patients (100%) followed by vague abdominal discomfort in 36 patients (90%) and dragging pain at hernia site in 16 patients (40%). All patients underwent repair of incisional hernia using polypropylene mesh which was placed in retromuscular preperitoneal position. Complications occurred were wound infection in 4 patients (10%), serum collection in 2 patients (5%), prolonged ileus in 2 patients (5%), sinus formation in only 1 (2.5%), hernia recurrence in 1 patient (2.5%). There was no mortality in study. Patients were followed up at 3 weeks, 6 weeks, 3 months, 6 months and 12 months. Conclusion:- Mesh repair was found very effective method of dealing with incisional hernia.