Intra-Abdominal Placement of Antimicrobial-Impregnated Mesh is Associated with Noninfectious Fever

2006 ◽  
Vol 72 (12) ◽  
pp. 1205-1209 ◽  
Author(s):  
William S. Cobb ◽  
B. Lauren Paton ◽  
Yuri W. Novitsky ◽  
Michael J. Rosen ◽  
Kent W. Kercher ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
In Vivo Models ◽  
Postoperative Fever ◽  
Dual Mesh

The antimicrobial, silver/chlorhexidine, when impregnated on mesh has been demonstrated to resist mesh infection in in vitro and in vivo models. The clinical, human systemic response to intraperitoneal placement of silver/chlorhexidine-impregnated mesh has not been investigated to date. Between October 2002 and November 2004, all in-patients undergoing laparoscopic ventral hernia repair were retrospectively analyzed. All repairs used expanded polytetraflouroethylene (ePTFE) Dual Mesh (DM) or ePTFE impregnated with silver/chlorhexidine, Dual Mesh Plus (DM+). Patient demographics, hernia characteristics, mesh type, operative details, and hospital course data were collected. Noninfectious fevers were defined as a temperature greater than 100.4 F without an identified source. Standard statistical methods were used. During the 2-year study period, 120 patients underwent laparoscopic ventral hernia repair (DM = 55, DM+ = 65). The two groups were similarly matched in terms of age, body mass index, American Society of Anesthesiologists score, defect size, and mesh size. Postoperative fever without an identified source occurred in 10 (18.2%) patients with DM and in 25 (38.5%) patients using DM+ (P = 0.015). A multivariant analysis revealed that only mesh type and body mass index predicted postoperative fever. All fevers resolved within the first 72 hours in the DM patients; however, 16 per cent of the DM+ group had persistent fevers of unknown origin after 72 hours. Within the DM+ group, patients with postoperative fevers had significantly longer postoperative stays (4.8 days vs 3.0 days; P = 0.009). The use of antimicrobial-impregnated ePTFE mesh with silver/chlorhexidine in laparoscopic ventral hernia repair is associated with noninfectious postoperative fever. In our patients, the evaluation and management of these fevers resulted in a significantly longer hospital stay.

scholarly journals Role of Tranexamic Acid for Seroma Prevention in Obese Patients Undergoing Laparoscopic Ventral Hernia Repair Under Spinal Anesthesia

2021 ◽  
Vol 15 (10) ◽  
pp. 3488-3490
Author(s):  
Rizwan Khan ◽  
Mahabub Aalam ◽  
Naeem Ahmed ◽  
Muddasar Pervaiz ◽  
Zahid Saeed
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Tranexamic Acid ◽  
Spinal Anesthesia ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Seroma Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Obese Patients

Objective: The aim of this study is to determine the effectiveness of tranexamic acid for seroma prevention in obese patients undergoing laparoscopic ventral hernia repair under spinal anesthesia. Study Design: Cross sectional study Place and Duration: Jinnah Postgraduate Medical Center (JPMC) Karachi, 1st July 2020 to 30th June 2021. Methods: There were one hundred and ten patients f both genders had abdominal hernia were included in this study. We have taken written consent from all the patients for detailed demographics age, sex and body mass index. Patients were undergone for laparoscopic ventral hernia repair under spinal anesthesia in OPD. The size and contents of the defect were determined by an abdominal and pelvic ultrasound. All patients received postoperative tranexamic acid. Drains were put in to measure the amount of seroma that was produced as a result of the procedure. SPSS 22.0 was used to analyze all of the data. Results: 42.23±6.55 years were the mean age of the patients. Mean Body mass index was 32.13±3.43 kg/m2. Majority of the patients 74 (67.3%) were females and rest of the patients 36 (32.7%) were males. In 91 (82.7%) cases seroma reduction was calculated within week. Only 41 of the 110 patients had drain output of less than 150 ml, 55 had drain output of 150-300 ml, and 14 had drain output greater than 300 ml. Seroma formation was found among 7 (6.4%) cases. Conclusion: Tranexamic acid was found to be efficient in minimizing postoperative seroma formation in ventral hernia repairs, according to the findings of this study. Keywords: Laparoscopic, Tranexamic acid, Plasminogen, Seroma, Obese Patients

Impact of body mass index on minimally invasive ventral hernia repair: an ACS-NSQIP analysis

Hernia ◽  
2019 ◽  
Vol 23 (5) ◽  
pp. 899-907 ◽  
Author(s):  
L. Owei ◽  
R. A. Swendiman ◽  
S. Torres-Landa ◽  
D. T. Dempsey ◽  
K. R. Dumon
Keyword(s):  
Body Mass Index ◽  
Minimally Invasive ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Acs Nsqip

The effect of increasing body mass index on wound complications in open ventral hernia repair with mesh

2019 ◽  
Vol 218 (3) ◽  
pp. 560-566 ◽  
Author(s):  
Luciano Tastaldi ◽  
David M. Krpata ◽  
Ajita S. Prabhu ◽  
Clayton C. Petro ◽  
Steven Rosenblatt ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Wound Complications ◽  
Open Ventral Hernia Repair

scholarly journals LAPAROSCOPIC VENTRAL HERNIA REPAIR

2018 ◽  
Vol 25 (04) ◽  
pp. 594-598
Author(s):  
Qaim Deen ◽  
Muhammad Adeel Kaiser ◽  
Qasim Farooq ◽  
Uzma Intisar ◽  
Amna Mazhar
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Low Cost ◽  
Abdominal Cavity ◽  
Case Series ◽  
Laparoscopic Ventral Hernia Repair ◽  
P Value ◽  
Prolene Mesh ◽  
Dual Mesh

Introduction: The common practice in laparoscopic ventral hernia repair (LVHR)is to place a dual mesh to prevent visceral adhesions, as majority of the patients are not ableto afford the expense of these meshes. We use prolene mesh to repair hernia. Objectives: Theaim of this study was to determine the frequency of success of laparoscopic ventral hernia repair(LVHR) using omentum as a barrier in patients presenting with ventral hernia. Study Design:Descriptive case series. Setting: Surgical Unit 3, Services Hospital Lahore, Pakistan. Period:6 months duration from 16th of July 2015 to 15st January 2016. Methods: 60 patients wereselected fulfilling the criteria from Department of General Surgery. 10mm telescope angled at 30degree was employed. Hernial contents were reduced but the peritoneal sac was left as such.The prolene mesh was inserted into the abdominal cavity through a port of 10mm diameterand fixed. Omentum was then sandwiched between abdominal wall and viscera. Patients werefollowed-up in OPD for 12 months. Results: Majority of the patients were females (56.7%) withthe mean age of 46.40 years and mean weight of 68 kg. The patients were averagely foundobese with a mean BMI of 25.40kg/m2. Majority of the patients (n=50, 83.3%) had success inhernia repair. Stratification of patients by age, gender and BMI showed (p-value was >0.05 in all3 cases) statistically insignificant difference between various subgroups. Conclusion: LVHR is auseful technique and simple proline mesh with omental barrier is a safe and low-cost alternativeto dual mesh technique.

Outcomes of Laparoscopic versus Open Fascial Component Separation for Complex Ventral Hernia Repair

2015 ◽  
Vol 81 (7) ◽  
pp. 714-719 ◽  
Author(s):  
Nathaniel Ng ◽  
Mallory Wampler ◽  
Humberto Palladino ◽  
Francisco Agullo ◽  
Brian R. Davis
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Body Mass ◽  
Ventral Hernia Repair ◽  
Hernia Recurrence ◽  
Component Separation ◽  
Physical Exam ◽  
Recurrence Rates

Ventral hernia recurrence rates have improved with advancements in technique. Open and laparoscopic fascial component separation techniques improve recurrence rates by allowing a tension free closure. This study examines laparoscopic component separation (LCS) and open component separation (OCS) techniques in the repair of complex ventral hernias and compares factors affecting patient outcomes. A retrospective chart review of patients who underwent ventral hernia repair with LCS and OCS was conducted between 2009 and 2013. Patient characteristics and outcomes were documented. Hernia recurrence was determined using physical exam and computed tomography if physical exam was equivocal. Univariate and multivariate analyses were performed. Ten patients underwent LCS and 38 underwent OCS. The rate of wound infection in the LCS group was 20 per cent versus 50 per cent in the OCS group. The overall rate of recurrence after LCS was 20 per cent, and 26 per cent in the OCS group. For body mass index > 30, the recurrence rate was 20 per cent in the LCS group and 29 per cent ( P = 0.5) in the open group. The use of LCS demonstrates a trend in the reduction of hernia recurrence and wound infection overall and in patients with body mass index > 30 compared with OCS.

Impact of body mass index on open ventral hernia repair: A retrospective review

Surgery ◽  
2017 ◽  
Vol 162 (6) ◽  
pp. 1320-1329 ◽  
Author(s):  
Lily Owei ◽  
Robert A. Swendiman ◽  
Rachel R. Kelz ◽  
Daniel T. Dempsey ◽  
Kristoffel R. Dumon
Keyword(s):  
Body Mass Index ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Body Mass ◽  
Retrospective Review ◽  
Ventral Hernia Repair ◽  
Open Ventral Hernia Repair

scholarly journals Long term outcome and elasticity of a polyester mesh used for laparoscopic ventral hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
P. J. O’Dwyer ◽  
C. Chew ◽  
H. Qandeel
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Ct Scans ◽  
Unique Problem ◽  
Polyester Mesh

Abstract Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. Methods All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24–48 months) and 104 months (range 92–116 months). In addition, CT scans of the abdomen and pelvis performed for any reason on these patients during the follow up period were reviewed by a consultant gastrointestinal radiologist. Mechanical failure testing of the mesh was also performed. Results Thirty-two of the 100 patients assessed for ventral hernia repair had a laparoscopic repair with a polyester mesh. Nineteen (59%) had CT scans performed during the follow-up period. No recurrence was recorded at 34 months, while three (9.4%) had a recurrence at 104 months. Two had central breakdown of the mesh at 81 and 90 months, while 1 presented acutely at 116 months after operation. Mesh had stretched across the defect by an average of 21% (range 5.7–40%) in nine patients. Mechanical testing showed that this mesh lost its elasticity at low forces ranging between 1.8 and 3.2 N/cm. Conclusion This study shows that late recurrence is a problem following laparoscopic ventral hernia repair with polyester mesh. The mesh loses it elasticity at a low force. This combined with degradation of mesh seems the most likely cause of failure. This is unlikely to be a unique problem of polyester mesh and further long-term studies are required to better assess this operative approach to ventral hernia repair.

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