Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST).
BACKGROUND
Hernias around ostomies are a very common complication, exceeding 50%. Only a few studies deal with the prophylactic use of mesh to prevent parastomal hernia revealing promising results.


METHODS
Twenty-two patients undergoing elective rectal surgery with a permanent colostomy--one with an ileostomy and two needing surgical correction of a preexisting colostomy--were enrolled in a prospective study. A specially designed mesh made of polyvinylidene fluoride with a central whole and a funnel arising (Dynamesh IPST) was prophylactically implanted using an intraperitoneal onlay technique. The patients were followed for a median of 11 (range 2-19) months by clinical examination every 3 months.


RESULTS
No infection or any other adverse effect was observed, and no parastomal hernia or stoma protrusion could be detected clinically. Twelve patients had a routine computed tomography after 6 months, which also excluded any hernia formation.


CONCLUSIONS
The prophylactic use of Dynamesh IPST) is a safe and effective procedure preventing stoma complications such as hernia formation or prolapse, at least in the short run.
Berger
D
D
Department of Surgery, Stadtklinik, Balgerstrasse 50, 76532 Baden-Baden, Germany. d.berger@klinikum-mittelbaden.de
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy; D005260:Female; D006555:Hernia, Ventral / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D013526:Surgical Mesh; D016896:Treatment Outcome; D005465:Fluorocarbon Polymers
D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers