The treatment results of patients with postoperative ventral hernias after multi-stage surgery of open abdominal gunshot wounds (improvement of hernioplasty-technique)
Keywordsabdominal gunshot wound, postoperative ventral hernia, surgical treatment, composite endoprosthesis, microfilament mesh
Aim: to compare a new technique of the tension-free abdominal wall repair for postoperative ventral hernia after multi-stage surgery of open abdominal gunshot wounds with the open traditional and laparoscopic approaches.
Materials and methods. Treatment results of the 86 patients with postoperative ventral hernias after multi-stage surgery of the open abdominal gunshot wounds, which were divided into 2 groups. The main group included 42 patients in whom surgical treatment was carried out according to the developed method of the tension-free abdominal wall repair for postoperative ventral hernia after multi-stage surgical treatment of the open abdominal gunshot wounds. 1st and 2nd comparison group included 44 patients who were undergone an open traditional allohernioplasty and laparoscopic approaches with the composite mesh installation. Treatment results were followed up until 1 year after surgery.
Results. In the main group of patients early postoperative complications were observed in 3 (25.0%): postoperative seroma – 2 (16.7%), postoperative wound infiltrate – 1 (8.3). Among patients of 1st and 2nd comparison group cases of postoperative complications were diagnosed in 11 (61.1%): 2 (11.1%) patients – festering wounds, 4 (22.2%) – peri-implant seroma, 3 (16.7%) – infiltration of the surgical wound, 1 (5.6%) – skin edges necrosis, 1 (5.6%) – failure of sutures of the surgical wound. The recurrences of ventral hernias were obtained in 3 (16.7%) patients from comparison group. However, there were no cases of postoperative ventral hernia recurrence in the main group of patients (p = 0.03).
Conclusion. А new technique of the tension-free abdominal wall repair for postoperative ventral hernia without disadvantages after multi-stage surgery of the open abdominal gunshot wounds, which allows to reduce the frequency of postoperative complications of surgical treatment and recurrence of the disease.
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