Expanded polytetrafluoroethylene patches used in the intraperitoneal or extraperitoneal position for repair of incisional hernias of the anterolateral abdominal wall

Abstract

Few large studies of the use of expanded polytetrafluoroethylene (ePTFE) in incisional hernia repairs have been done. We performed such a study of ePTFE patches implanted extraperitoneally or intraperitoneally. The records of all patients in whom an ePTFE patch was used to repair an incisional hernia in 1987 to 1994 were reviewed retrospectively. An ePTFE patch was implanted in 158 patients, extraperitoneally in 98 and intraperitoneally in 60. There were no perioperative deaths. Serious postoperative complications, including 3 cases of sepsis (intraperitoneally placed patch), occurred in 6 patients (4%). With a mean follow-up of 37 months (range 12 to 90), there were 2 cases of late sepsis (with an extraperitoneal patch) and 6 recurrences (4 with an intraperitoneal patch). The ePTFE prostheses used in incisional hernia repair are well tolerated in the intraperitoneal position. Their effectiveness in the extraperitoneal position may be comparable to that of mesh but with a lower rate of sepsis.