Abdominal wall reconstruction with components separation and mesh reinforcement in complex hernia repairReport as inadecuate




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BMC Surgery

, 14:25

Gastrointestinal tract and endocrine surgery

Abstract

BackgroundAbdominal closure in the presence of enterocutaneous fistula, stoma or infection can be challenging. A single-surgeon’s experience of performing components separation abdominal reconstruction and reinforcement with mesh in the difficult abdomen is presented.

MethodsMedical records from patients undergoing components separation and reinforcement with hernia mesh at Royal Liverpool Hospital from 2009 to 2012 were reviewed. Patients were classified by the Ventral Hernia Working Group VHWG grading system. Co-morbidities, previous surgeries, specific type of reconstruction technique, discharge date, complications and hernia recurrence were recorded.

ResultsTwenty-three patients’ 15 males, 8 females notes were reviewed. Median age was 57 years range 20-76 years. Median follow-up at the time of review was 17 months range 2-48 months. There were 13 grade III hernias and 10 grade IV hernias identified. Synthetic mesh was placed to reinforce the abdomen in 6 patients, cross-linked porcine dermis was used in 3, and a Biodesign Hernia Graft was placed in 14. Complications included wound infection 13%, superficial wound dehiscence 22%, seroma formation 22% and stoma complications 9%. To date, hernias have recurred in 3 patients 13%.

ConclusionsComponents separation and reinforcement with biological mesh is a successful technique in the grade III and IV abdomen with acceptable rate of recurrence and complications.

KeywordsHernia Contamination Infection Components separation Biologic graft Mesh Reinforcement AbbreviationsVHWGVentral hernia working group.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2482-14-25 contains supplementary material, which is available to authorized users.

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Author: Claire L Nockolds - Jason P Hodde - Paul S Rooney

Source: https://link.springer.com/article/10.1186/1471-2482-14-25







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