MANAGEMENT OF IRREDUCIBLE HERNIA USING POLYPROPYLENE MESH

Abstract

Background: Incarceration of abdominal wall hernia is a frequent problem. Moreover, using polypropylene mesh in management of acute hernia is infrequently performed. Objective: To detect the relation between postoperative surgical site infections (SSI) in patients with irreducible abdominal wall hernia using polypropylene mesh in their hernia repair. Patients and methods: Our study included 30 irreducible abdominal hernia patients even with strangulation and/or obstruction who were managed by polypropylene meshes. This prospective interventional study was conducted at the Department of General Surgery, Al-Zahraa University Hospital from November 2018 to November 2019. All patients, who presented with irreducible, obstructed or strangulated abdominal wall hernias, were included in this study. Results: Preoperative hernia complications were 66.7% irreducibility only, 3.3% hematoma, 3.3% obstructed, 6.7% strangulated, 20% strangulated obstructed. Presence of toxic fluid in the hernia sac was 23.32%. This study revealed seroma (SSI) in 36.7%. There were significant differences between seroma formation regarding preoperative hernia complications rather than irreducibility (p=0.013), presence of toxic fluid in the hernia sac (p=0.029). There were high significant relation between seroma (SSI) in cases operated emergency than in cases operated electively (p < 0.001). Seroma formation was higher in cases with past history of abdominal wall surgery (p < 0.001). Conclusion: Seroma formation rates were higher in irreducible strangulated and /or obstructed (urgent cases) hernia repair using polypropylene mesh but controllable, and no deep infection was developed in any case. Therefore, use of polypropylene mesh in acute urgent hernia cases was safe and advisable.