The Use of Prosthetic Mesh in the Emergency Management of Acute Incarcerated Inguinal Hernias

2019 ◽  
Vol 26 (3) ◽  
pp. 344-349 ◽  
Author(s):  
Jing Liu ◽  
Zhiwei Zhai ◽  
Jie Chen
Keyword(s):  
Wound Infection ◽  
Mesh Repair ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Wound Infection Rate ◽  
Prosthetic Mesh ◽  
Incarcerated Inguinal Hernia ◽  
Inguinal Hernias ◽  
Significant Difference ◽  
Prosthetic Mesh Repair

Introduction. Tension-free hernia repair has been regarded as a gold standard treatment for selected inguinal hernias, but the use of prosthetic mesh in acute incarcerated inguinal hernias is controversial. Our study focused on evaluating the safety and efficacy of the prosthetic mesh repair for emergency cases. Methods. Patients with acute incarcerated inguinal hernias who underwent emergency prosthetic mesh repair during 2009 to 2014 at our department were included. Patient characteristics, operative approaches and results, and complications were retrospectively analyzed. Results. A total of 167 patients were included in our study. One hundred and twenty-two patients underwent open surgery while the remaining 45 patients underwent transabdominal preperitoneal laparoscopic approach. The hernia was indirect inguinal in 133 patients (79.6%), direct inguinal in 15 patients (9.0%), and femoral in 19 patients (11.4%). The overall wound infection rate of these patients was 3%. Nonviable intestinal resection was performed in 25 patients (8.4%), only 2 of whom underwent wound infection. Another 3 patients who developed wound infection had viable hernia content. There was no mesh-related infection. There was no statistically significant difference in wound infection rates between patients with viable hernia contents and those with nonviable contents ( P < .05). Conclusion. The use of the prosthetic mesh in the treatment of acute incarcerated inguinal hernia is safe and effective. Nonviable intestinal resection cannot be regarded as a contradiction of the mesh repair.

Recommendations for patient management after manual reduction of incarcerated inguinal hernia: a literature review

2020 ◽  
Vol 99 (9) ◽  
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Tissue Repair ◽  
Laparoscopic Approach ◽  
Current Evidence ◽  
Surgical Team ◽  
Incarcerated Inguinal Hernia ◽  
Manual Reduction ◽  
Inguinal Hernias ◽  
Increased Risk

Introduction: Topic of this review is to provide a systematic overview of the current evidence on the management of patients after manual reduction of an incarcerated inguinal hernia. Methods: Available literature regarding incarcerated or strangulated inguinal hernias published until March 2019 was obtained and reviewed. 32,021 papers were identified, of which only 20 were of a sufficient value to be used in this review. Results: The terms ‘incarcerated’ and ’strangulated’ are used interchangeably in the literature making separate analysis of these two entities almost impossible, although manual reduction is very unlikely to be successful when the hernia has strangulated contents. Following successful manual reduction, mesh repair is generally superior compared to pure tissue repair with regard to recurrence rates. Nevertheless, mesh repair is associated with a significant increase in the surgical site infection (SSI) rate, especially when bowel necrosis is present. The laparoscopic approach provides the benefits of avoiding an unnecessary laparotomy and reducing associated morbidity, but it does require the availability of appropriate equipment and an appropriately skilled surgical team. Conclusion: A mesh repair is generally superior to a pure tissue repair in the surgical management of emergency inguinal hernias, reducing the recurrence rate, but can be associated with an increased risk of SSI depending on the level of contamination. The laparoscopic approach is recommended if an experienced surgical team and necessary equipment are available.

scholarly journals Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

2016 ◽  
Vol 33 (4) ◽  
pp. 434-440 ◽  
Author(s):  
Cihad Tatar ◽  
Ishak Sefa Tuzun ◽  
Tamer Karsidag ◽  
Mehmet Celal Kizilkaya ◽  
Erdem Yilmaz
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Prosthetic Mesh ◽  
Incarcerated Inguinal Hernia ◽  
Prosthetic Mesh Repair

Prosthetic Mesh Repair in the Emergency Management of Acutely Strangulated Groin Hernias with Grade I Bowel Necrosis: A Rational Choice

2018 ◽  
Vol 84 (2) ◽  
pp. 215-219 ◽  
Author(s):  
Sheng-Jun Duan ◽  
Shao-Bo Qiu ◽  
Nai-Yong Ding ◽  
Hua-Shui Liu ◽  
Nai-Shun Zhang ◽  
...  
Keyword(s):  
Emergency Management ◽  
Wound Infection ◽  
Rational Choice ◽  
Mesh Repair ◽  
Prosthetic Mesh ◽  
Suture Repair ◽  
Primary Suture ◽  
Bowel Necrosis ◽  
Groin Hernias ◽  
Prosthetic Mesh Repair

The aim of this study was to determine the feasibility of prosthetic mesh repair according to the degree of bowel necrosis in the emergency management of acutely strangulated groin hernias. Emergency prosthetic mesh repair versus primary suture repair was randomly performed in 208 consecutive strangulated groin hernia patients with bowel necrosis between January 2005 and August 2016. The degree of bowel necrosis of each patient was determined according to a modified three-grade classification system. Patient characteristics sorted by repair method were analyzed by using Pearson's chi-squared tests. Correlations between mortality and wound-related morbidity with bowel necrosis grade and repair method were analyzed. There was no difference in gender, age, body mass index, comorbid diseases, hernia type (left or right, primary or recurrent), necrosis grade, and mortality between the mesh repair and suture repair groups (all P > 0.05). However, with regard to wound-related morbidity, there was significant difference between the two groups ( P < 0.05). Mortality and wound-related morbidity showed significant relationship with necrosis grade, especially with regard to postoperative wound infection ( P < 0.001). The wound infection rate with mesh repair was significantly higher than that with primary suture in Grade II and III necrosis patients ( P < 0.05), but there was no difference in Grade I patients ( P > 0.05). The use of prosthetic mesh in the emergency repair of acutely strangulated groin hernias seems to be as safe as suture-only repair in patients with noninfected strangulated bowel (Grade I necrosis). The use of prosthetic mesh repair is a rational choice made based on the degree of bowel necrosis in the emergency management of acutely strangulated hernias.

scholarly journals COMPLICATED INGUINAL HERNIAS;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Naveed Akhtar ◽  
Syed Shams- Ul-Hassan ◽  
Muhammad Sabir ◽  
M. Nauman Ashraf
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Wound Infection ◽  
P Value ◽  
Emergency Setting ◽  
Complication Rates ◽  
Success Rates ◽  
Inguinal Hernias ◽  
Significant Difference ◽  
The Mean

Background: Herniorrhaphy and hernioplasty are the two most common modalities used with different degree of success and complication rates in the treatment of inguinal hernia. Several studies show that use of mesh is superior to the non-mesh operations in inguinal hernia surgery.It is generally believed that the use of biomaterials should be limited to non-infected surgical fields.Now the concept regarding use of mesh in complicated hernias is changing as shown by many studies. Current study is being planned to observe the outcomes of the mesh hernioplasty in treatment of complicated inguinal hernias in emergency so that in future appropriate and safe technique may be suggested for repair of complicated hernias in emergency setting. Objectives: To compare the outcome of hernioplasty and herniorrhaphy in emergency for the treatment of complicated (Irreducible/obstructed) inguinal hernias regarding wound infection and hospital stay. Material & Methods:… Study Design: Randomized control trial. Setting: Surgical ward, Sheikh Zayed Hospital, Rahim yar khan. Period:09 months from 01-01-2016 to 30-09-2016. Sample Size: A total of 64 patients with 32 patients were included in each group, with confidence level of 95% and power of 80% and anticipated mean level of hospital stay in group 1 of 5±3.4 days versus 3±2.1 days in group 2. Sampling Technique: Non-probability, consecutive sampling. Results: In this study there were total 64 cases with 32 in each group. The mean age was 41.69±11.06 years and the mean duration of hernia obstruction was 12.83±4.97 hours. There was no significant difference in terms of age, duration of hernia and hernial obstruction between both groups. Seroma was seen in 5 (7.81%) out of 64 cases while wound infection was seen in 8 (12.50%) of cases. Seroma was seen in 2 (6.25%) out of 30 cases in herniorrhaphy as compared to 3 (9.38%) out of 32 cases with hernioplasty with p value of 0.64. Wound infection was seen in equally 4 (12.50%) out of 32 cases in both groups with p value of 1.0. Duration of hospital stay was 4.66±1.36 in patients with herniorrhaphy as compared to 4.53±1.37 days with hernioplasty with p value= 0.82. There was no significant difference in terms of age groups, duration of hernia and its obstruction between both groups regarding seroma. There was also no significant association among any of the confounding factors regarding the wound infection and length of the hospital stay between the both groups. Conclusion: We can perform hernioplasty as compared to herniorrhaphy for complicated inguinal hernia with similar complications and better success rates in the same emergency setting.

scholarly journals Repair of incisional hernias - Experience with a combined fascial and prosthetic mesh repair

2012 ◽  
Vol 1 (2) ◽  
pp. 6-9
Author(s):  
SM Amjad Hossain ◽  
Khairun Nahar
Keyword(s):  
Hospital Stay ◽  
Mesh Repair ◽  
Rectus Sheath ◽  
Early Mobilization ◽  
Prosthetic Mesh ◽  
Biliary Surgery ◽  
Total Period ◽  
Incisional Hernias ◽  
Prosthetic Mesh Repair

Repairs of incisional (ventral) hernia is one of the commonly performed operation in Bangladesh. This is a prospective study conducted in Shaheed Suhrawardy Hospital, Dhaka and a private Hospital (BDM Hospital) at Dhaka city from June 2001 to 31st May 2004 with a total period of 3 years and with total patients 43. Incisional hernias develop in upto 11% of surgical abdominal wounds with a possible recurrence, following repairs of 44%. There are several methods of repair of incisional hernias, including laparoscopic method of repair which is gaining popularity day by day. But we describe our experience with a combined fascial and prosthetic mesh repair. Of total 43 patients treated, 27 were female & 16 were male. The original operation was gynaecological in 27, bowel related surgery in 15 cases & biliary surgery in 4 patients. The incisions were midline in 31 patients, transverse in 10 patients and paramedian in 2 patients. The hernias were considered subjectively to be large in 21, medium in 16 and small in 6 patients. A parameter was compiled for each patient, noting intraoperative and post postoperative complications , post operative hospital stay and analgesic requirements. Post operative complications included seroma formation in 6 patients. One patient developed wound infection and require removal of the mesh 10 Control infection. Post operative hospital stay ranged from 2 to 17 days. Of total 43 patients 36 were available for follow- up. Seven drops from follow up. Follow up was from 6 months to 36 months. One (2.5%) of these patients complained of persistent lump and one reported persistent pain. Hernia recurrence in one patient (2.5%) , 35 was found to have no recurrence. We advocate these technique because it is applicable to all hernias,most of the mesh is behind the rectus sheath and has two points of fixation, it is relatively pain free allowing early mobilization has a less complication rate and low recurrence rate.DOI: http://dx.doi.org/10.3329/jssmc.v1i2.12158 Journal of Shaheed Suhrawardy Medical College Vol.1, No.2, December 2009 p.6-9

Prosthetic mesh repair of large and recurrent diaphragmatic hernias

2007 ◽  
Vol 21 (5) ◽  
pp. 737-741 ◽  
Author(s):  
Nir Lubezky ◽  
Boaz Sagie ◽  
Andrei Keidar ◽  
Amir Szold
Keyword(s):  
Mesh Repair ◽  
Prosthetic Mesh ◽  
Prosthetic Mesh Repair ◽  
Diaphragmatic Hernias
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