Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated ventral hernias: a seven years study

Abstract

Purpose: The aim of this prospective study was to present a 7-year experience with the use of prosthetic mesh repair in the management of the acutely incarcerated and/or strangulated ventral hernias.

Methods: Patients with acutely incarcerated and/or strangulated ventral hernias were treated by emergency repair of the hernia using an onlay Prolene mesh. The presence of non-viable intestine necessitating resection-anastomosis of the bowel was not considered a contraindication to the use of mesh.

Results: The present study included 80 patients. Their age ranged from 25 to 86 years with a mean of 56.1 ± 13.2 years. The hernia was para-umbilical in 71 patients (88.75 %), epigastric in 6 patients (7.5 %) and incisional in 3 patients (3.75 %). Eighteen patients (22.5 %) had recurrent hernias. Resection-anastomosis of non-viable small intestine was performed in 18 patients (22.5 %). There were 2 perioperative mortalities (2.5 %). Complications were encountered in 17 patients (21.3 %) and included wound sepsis in 9 patients (11.25 %), seroma formation in 5 patients (6.25 %), chest infection in 4 patients (5 %), deep vein thrombosis in 1 patient (1.25 %) and mesh infection in another patient (1.25 %). Follow-up duration ranged from 12 to 84 months with a mean of 49.9 ± 19.9 months. Only one recurrence was encountered throughout the study period.

Conclusions: The use of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated ventral hernias is safe. The presence of non-viable intestine cannot be regarded as a contraindication for prosthetic repair.