The treatment results of patients with postoperative ventral hernias after multi-stage surgery of open abdominal gunshot wounds (improvement of hernioplasty-technique)

Abstract

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. 1^st and 2^nd 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 1^st and 2^nd 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.