Prosthetic repair of acutely incarcerated groin hernias: a prospective clinical observational cohort study

Abstract

Mesh usage in repair of acutely incarcerated hernia is still a concern owing to infectious complications. The aim of this prospective clinical observational cohort study was to evaluate factors that increase the risk of bowel necrosis and to document the clinical outcome of the patients with acutely incarcerated groin hernias treated by non-absorbable mesh. Ninety-five adult patients with acutely incarcerated groin hernias who underwent prosthetic herniorrhaphy from 1997 to 2005 were prospectively included. The patients were evaluated in two groups, which were based on whether the bowel resection was required (group 1) or not (group 2). Demographics and characteristics of patients in each group were compared. Chi-square, Fisher's exact, and Mann-Whitney U test were used to determine the statistical significance (p < 0.05). Bowel resection was required in 14 (14.7%) and not required in 81 (85.3%) patients. Duration of symptoms longer than 6 h was an important factor for determining the need for resection (p = 0.026). No significant difference was noted concerning the development of wound infection, postoperative recurrence, morbidity, and mortality rates between the two groups. Our results suggest that duration of symptoms longer than 6 h was an important factor for determining the need for resection. The use of non-absorbable mesh for acutely incarcerated groin hernia repair is effective and may be used with an acceptable incidence of wound infection and recurrence even when intestinal necrosis was present.