The treatment results of patients with postoperative ventral hernias after multi-stage surgery of open abdominal gunshot wounds (improvement of hernioplasty-technique)
DOI:
https://doi.org/10.12775/JEHS.2020.10.07.024Keywords
abdominal gunshot wound, postoperative ventral hernia, surgical treatment, composite endoprosthesis, microfilament meshAbstract
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.
References
Shekelle PG, Woolf SH, Eccles M, Grimshaw J. Clinical guidelines: developing guidelines. BMJ 1999;318:593-6.
Malone DL, Genuit T, Tracy JK, Gannon C, Napolitano LM. Surgical site infections: reanalysis of risk factors. J Surg Res 2002;103:89-95.
Goodney PP, Birkmeyer CM, Birkmeyer JD. Short-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. Arch Surg 2002;137:1161-5.
Khomenko I. Hydrodynamic rupture of liver in combat patient: a case of successful application of “damage control” tactic in area of the hybrid war in East Ukraine / I. Khomenko, V. Shapovalov, Ie. Tsema, G. Makarov, R. Palytsia, Ie. Zavodovskyi, I. Ishchenko, A. Dinets, V. Mishalov // Surgical Case Reports. - 2017. - Vol. 3. - P. 88-94.
Khomenko I.P. Dynamika mikrobnoi kontaminatsii vohnepalnoi rany pid chas kompleksnoho khirurhichnoho likuvannia / I.P. Khomenko, Ye.V. Tsema, Yu.V. Shapovalov, S.V. Tertyshnyi, P.O. Shkliarevych // Khirurhiia Ukrainy. – 2018. – № 1. – S. 7-13.
Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 2004;240:578-83.
Houck JP, Rypins EB, Sarfeh IJ, Juler GL, Shimoda KJ. Repair of incisional hernia. Surg Gynecol Obstet 1989;169:397-9.
Khomenko I. Pulmonary artery embolism by a metal fragment after a booby trap explosion in a combat patient injured in the armed conflict in East Ukraine: a case report and review of the literature / I. Khomenko, Ie. Tsema, P. Shklyarevych, K. Kravchenko, V. Holinko, S. Nikolaienko, S. Shypilov, O. Gerasimenko, A. Dinets, V. Mishalov / Journal of Medical Case Reports. – 2018. – Vol. 12. P. 330.
Khomenko I.P. Dynamika mikrobnoi kontaminatsii vohnepalnoi rany pid chas kompleksnoho khirurhichnoho likuvannia / I.P. Khomenko, Ye.V. Tsema, Yu.V. Shapovalov, S.V. Tertyshnyi, P.O. Shkliarevych // Khirurhiia Ukrainy. – 2018. – № 1. – S. 7-13. [InUkrainian].
Celen O. Abdominal gunshot wounds: retrospective analysis of 164 patients / O. Celen, S. Oguz, M. Dogan // Ulus Travma Derg. – 2001. – Vol. 7, N. 4. – P. 258-261.
Hybalo R.V. Eksperymentalno-morfolohichne obhruntuvannia efektyvnosti formuvannia spoluchnotkanynnoho karkasa perednoi cherevnoi stinky zalezhno vid topohrafo-anatomichnoho roztashuvannia sitchastoho implantatu / R.V. Hybalo, Ye.V. Tsema, A.I. Batiuk, B.M. Koval // Khirurhiia Ukrainy. – 2018. – № 1. – S. 46-54. [InUkrainian].
Aprahamian С., Wittmann D.H., Bergstein J.M., Quebbeman E.J. Temporary abdominal closure (TAC) for planned relaparotomy (etappenlavage) in trauma / С. Aprahamian, D.H. Wittmann, J.M. Bergstein, E.J. Quebbeman // J. Trauma. 1990. – Vol. 30, N. 2. – P. 719-723.
Downloads
Published
How to Cite
Issue
Section
License
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 541
Number of citations: 0
