Summary
Between 1980 and 1996 the author operated at a teaching academic center and in a private hospital on 230 patients harboring ventral hernias. Fifty hernias were primary and one hundred eighty were incisional. Utilized techniques included direct tissue approximation or overlapping (N=35, recurrence rate 42%), ePTFE or polypropylene prostheses sutured to aponeurotic edges (N=147, recurrence rate 4.7%) and preperitoneal polyester prostheses (N=48, recurrence rate 2%). Nine wound infections occurred: three in clean, three in clean contaminated, and three in infected wounds, producing an overall 3.9 % infection rate. Thirteen markedly obese patients (Quetelet Index 31.9%) with gigantic multiply recurrent hernias offered a serious challenge requiring repeated procedures for recurrence, wound infection and mesh fragmentation. The technical transition leading to preperitoneal approaches utilizing polyester meshes lowered the overall complication rate and has become our procedure of choice until new prostheses are created.
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References
Andrews NJ (1981) Presentation and outcome of strangulated external hernia in a district general hospital. Br J Surg 68: 329
Bauer JJ, Salky BA, Gelernt IM, Kreel I (1987) Repair of large abdominal wall defects with expanded polytetrafluoroethylene. Ann Surg 206: 765–769
Cerise EJ, Busuttil RW, Craighead CC, Ogden WW (1975) The use of Mersilene mesh in repair of abdominal wall hernias: a clinical and experimental study. Ann Surg 181: 728–734
Chevrel JP, Flament JB (1995) Traitement des éventrations de la paroi abdominale. Encycl Med Chir Paris 40: 165
Dayton MT, Buchele BA, Shirazl SS, Hunt LB (1986) Use of an absorbable mesh to repair contaminated abdominal wall defects. Arch Surg 121: 954–960
Deysine M (1992) Hernia repair with expanded polytetrafluoroethylene. Am J Surg 164: 422–424
George CD, Ellis H (1986) The results of incisional hernia repair: a 12-year review. Ann Roy Coll Surg Eng 68: 185–187
Gilbert AI, Graham MF (1997) Infected grafts of incisional hernioplasties. Hernia 1: 77–81
Gristina AJ. (1987) Biomaterial-centered infection: microbial additions vs tissue integration. Science 237: 1588–1595
Law NW, Ellis H (1988) Adhesion formation and peritoneal healing on prosthetic materials. Clin Mater 3: 95–101
Pollak R (1989) Strangulating external hernia. In: Nyhus LN, Condon RE (eds) Hernia, 3rd edn. Lippincott, Philadelphia, pp 273–284
Rives J, Pire JC, Flament JB, Palot JP (1987) Major incisional hernias. In: Chevrel JP (ed) Surgery of the Abdominal Wall. Springer-Verlag, Paris Berlin Heidelberg, pp 116–144
Romiev I, Willett WC, Stampferd MJ, et al. (1988) Energy intake and other determinants of relative weight. Am J Clin Nutr 47: 406–412
Salvati EA, Chekofsky KM, Brause BD, Wilson PD (1982) Reimplantation in infection: a twelve year experience. Clin Orthop 170: 62
Schumpelick V, Conze J, Klinge U (1996) Die praperitoneale Netzplastik in der Reparation der Narbenhernie. Chirurg 67: 1028–1035
Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13: 545–554
Wantz GE (1991) Atlas of hernia surgery. Raven Press, New York, pp 179–216
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Deysine, M. Ventral herniorrhaphy: Treatment evolution in a hernia service. Hernia 2, 15–18 (1998). https://doi.org/10.1007/BF01207768
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DOI: https://doi.org/10.1007/BF01207768