title: Management of strangulated abdominal wall hernias with mesh; early results.
abstract: OBJECTIVE
  Surgery for abdominal wall hernias is a common procedure in general surgery practice. The main causes of delay for the operation are comorbid problems and patient unwillingness, which eventually, means that some patients are admitted to emergency clinics with strangulated hernias. In this report, patients who admitted to the emergency department with strangulated adominal wall hernias are presented together with their clinical management.
  
  
  METHODS
  Patients who admitted to our clinic between January 2009 and November 2011 and underwent emergency operation were included in the study retrospectively. Demographic characteristics, hernia type, length of hospital stay, surgical treatment and complications were assessed.
  
  
  RESULTS
  A total 81 patients (37 female, 44 male) with a mean age of 52.1±17.64 years were included in the study. Inguinal, femoral, umbilical and incisional hernias were detected in 40, 26, 9 and 6 patients respectively. Polypropylene mesh was used in 75 patients for repair. Primary repair without mesh was used in six patients. Small bowel (n=10; 12.34%), omentum (n=19; 23.45%), appendix (n=1; 1.2%) and Meckel's diverticulum (n=1; 1.2%) were resected. Median length of hospital stay was 2 (1-7) days. Surgical site infection was detected in five (6.2%) patients. No significant difference was detected for length of hospital stay and surgical site infection in patients who had mesh repair (p=0.232 and 0.326 respectively).
  
  
  CONCLUSIONS
  The need for bowel resection is common in strangulated abdominal wall hernias which undergo emergency operation. In the present study, an increase of morbidity was seen in patients who underwent bowel resection. No morbidity was detected related to the usage of prosthetic materials in repair of hernias. Hence, we believe that prosthetic materials can be used safely in emergency cases.
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozbagriacik
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gurhan
authors.initials: G
authors.lastname: Bas
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Basak
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Sisik
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Acar
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ilyas
authors.initials: I
authors.lastname: Kudas
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Yucel
authors.affiliation: Department of General Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Ozpek
authors.affiliation: Department of General Surgery, Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Alimoglu
keywords: Abdominal hernia; emergency treatment; inguinal hernia