Background
The application of prosthetic mesh hernioplasty of ventral hernias in emergency potentially infected conditions is still a matter of debate because of the high possibility of infection of the surgical site (SSI), and still many surgeons in clinical practice do not favor the application of prosthetic mesh in emergency circumstances. Our study compared the repair of ventral hernias in complicated conditions together with either application of synthetic mesh or not and reviewed their outcomes regarding surgical site occurrence and incidence of recurrence of hernia.
Patients and methods
During the period from January 2020 to May 2021, 86 cases of incarcerated or strangulated ventral hernias admitted to Tanta University Emergency Hospital were randomized to be repaired with either the application of synthetic mesh or without. Data were collected and tabulated.
Results
A total of 86 patients were included. Overall, 31 (36%) presented with incarcerated ventral hernias and 55 (64%) patients presented with strangulated ones, of whom 11 patients required bowel resection. Moreover, 43 (50%) patients were managed by onlay mesh repair, and the other 43 (50%) patients had only primary suture repair. SSI occurred in eight (9.3%) patients, with nearly equal presentation in both groups. Six patients presented with recurrence during the 12-month follow-up; five of them were in the suture repair group. Diabetes mellitus, multiple comorbidities, American Society of Anesthesiologists score III, bowel resection and previous recurrence were independent predictors for SSI.
Conclusion
Prosthetic mesh repair of emergency-presenting ventral hernias showed a lower incidence of recurrence and acceptable rate of surgical site occurrence.