Late complications of incisional hernias following prosthetic mesh repair.
BACKGROUND
Incisional hernias still continue to be a serious problem for surgeons. In this study, we aimed to investigate the effects of polypropylene mesh and mersilene mesh, which are frequently employed in incisional hernias, as well as the effects of their application techniques on late complications.


METHODS
Two-hundred-sixty-four open abdominal hernia repairs were performed between 1986--2000, using prosthetic materials: polypropylene mesh and mersilene mesh were used in hernia repair. Mesh was placed as onlay, underlay and sandwich techniques. Follow-up data were obtained from medical records.


RESULTS
Comparisons were made with respect to surgical techniques and to late complications such as recurrence, enterocutaneous fistula, intestinal obstruction, and infections. Enterocutaneous fistulas developed in two patients. Recurrence occurred in 6.4 per cent. Chronic infection and wound sinus formation occurred in 5 per cent. The causes of recurrence included smoking, cellulitis, chronic infection/sinus tract, upper abdominal localization, and obstruction. Fistula formation occurred in patients with no peritoneal prevention, which was statistically significant (p=0.012). Chronic infection/sinus tract was high in patients for whom mersilene mesh was used, and enterocutaneous fistula occurred in 2 patients.


CONCLUSIONS
To prevent late complications, it is necessary to avoid the contact of mesh with bowel.
Basoglu
M
M
Department of General Surgery, School of Medicine, Ataturk University, Erzurum, Turkey. mbasoglu@hotmail.com
Yildirgan
M I
MI
Yilmaz
I
I
Balik
A
A
Celebi
F
F
Atamanalp
S S
SS
Polat
K Y
KY
Oren
D
D
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005402:Fistula / Q000209:etiology; D005500:Follow-Up Studies; D006547:Hernia / Q000209:etiology; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011126:Polypropylenes; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013530:Surgical Wound Infection; D013997:Time Factors
D011093:Polyethylene Terephthalates; D011126:Polypropylenes; C025539:Lavsan