文摘
Purpose This retrospective comparative study analyzes the outcome of patients affected by incisional hernia in potentially contaminated or contaminated field, treated by three operative techniques. Methods 152 patients (62 M:90 F; mean age 65聽卤聽14聽years) underwent incisional hernia repair (January 2002鈥揓anuary 2012) in complicated settings. Criteria of inclusion in the study were represented by the following causes of admission: mesh rejection/infection, obstruction without gangrene but with possible peritoneal bacterial translocation, obstruction with gangrene, enterocutaneous fistula or simultaneous presence of ileo- or colostomy. The patients were divided into three groups: A (n聽=聽76), treated with primary closure technique; B and C (n聽=聽38 each), with reinforcement by synthetic or pericardium bovine mesh (Tutomesh庐), respectively. The prosthetic groups were divided into Onlay and Sublay subgroups. Results Significant decreases in C vs A were observed for wound infection (3 vs 37聽%) and recurrence (0 vs 14聽%), and in C vs B for wound infection (3 vs 53聽%), seroma (0 vs 34聽%) and recurrence (0 vs 16聽%). Patients with concomitant bowel resection (BR) (43聽%) showed (all P聽Onlay or Sublay subgroups. B-Sublay subgroup has (all P聽Onlay. Conclusions The pericardium bovine patch seems to be safe and effective to successfully repair ventral hernia in potentially contaminated operative fields, especially in association with bowel resection.