Role of Mesh Repair in incisional hernia

Abstract

Surgery Design: A case series study Purpose: 1) To study the protocol for repair of incisional hernia. 2) To compare different other methods of repair given in literature with prosthetic mesh repair in terms of advantages / disadvantages of the prosthetic repair. Suit & period: The study was conducted in Surgical Unit, Bahawal Victoria Hospital, Bahawalpur from August 19, 1997 to January 31, 2000. Material & method: This was a prospective type of case series study. Selection criteria of the patients in this study was that all adult patients of either sex being diagnosed as the case of incisional hernia and have undergone repair by the prosthetic mesh during this study period were included in the study. A record of patient`s data, previous surgery, the size of the defect, which gives idea about indication for surgery, was noted. A record of their postoperative course and a follow-up for four months was made. Results: In this study we have included 23 patients. Out of these 15 were female and 8 were male. The age was ranging from 28 - 65 years, with an average of 43 years. Patients presented with pain/ discomfort, Gradual increase in size of defect and unacceptable appearance in all patients, sub acute obstruction in 3 patients, Intestinal obstruction in 2 patients & Skin ulceration in 2 patients. Ten patients had got uneventful satisfactory post-operative course. Six patients developed wound infection; one patient developed seroma & was cured by needle aspiration & antibiotic. Five patients developed sinus. 2 of them cured without any surgical intervention with antiseptic dressings and antibiotics after culture and sensitivity. 3 needed exploration, 2 of them cured satisfactorily but in 1 patient because of continuing infection mesh was removed after one year and recurrence took place. No mortality, enterocutaneous fistula or haematoma was noted. One patient developed MY D.V.T. and was managed by Medical advice. Conclusion: Although wide variety of procedures has been adopted for recurrent ventral hernia repair. The prosthetic repair with prolene mesh is most cost effective and efficient method of dealing with incisional hernia.