P-015 POLY-4-HYDROXYBUTYRATE ABSORBABLE BARRIER COMPOSITE MESH AND POLY-PROLINE MESH: DUAL REPAIR FOR HUGE INCISIONAL HERNIA

Abstract

Abstract Introduction A giant incisional hernia is a serious challenge. Along with loss of domain, the ideal surgical management is difficult to identify, with various surgical techniques and meshes. Obesity and comorbidities in patients with diabetes add to difficulties in repairing incisional hernias with loss of domain. Herein, we present a case in which a double-mesh technique was performed for surgical repair of huge incisional hernias. Presentation of Case An 80-year-old male patient with multiple comorbidities presented to the clinic with multiple incisional hernias secondary to a missile injury. The huge incisional hernias affected the patient's daily life and limited his activities. Abdominal computed tomography showed multiple central and lateral incisional hernias. Through a midline laparotomy, a 30 × 35-cm poly-4-hydroxybutyrate/absorbable barrier composite (P4HB/ABC) mesh was sutured to the abdominal wall intraperitoneally, and then a 20 × 25-cm lightweight polypropylene (LWPP) mesh was sutured to the edge of the muscular defect. Discussion This report described the case of a patient with multiple huge abdominal hernias, which were repaired using the double-mesh technique. The patient had an uneventful postoperative recovery. However, the patient had a seroma during follow-up, which was managed conservatively. Conclusion This report described the usefulness and challenges of using the double-mesh technique for successful repair of multiple central and lateral incisional hernias. We used two types of meshes, P4HB/ABC and LWPP meshes, which yielded good outcomes and no hernia recurrence occurred in a 3-year follow-up.