Feasibility of mesh repair for strangulated abdominal wall hernias

Abstract

Background: Prosthetic mesh reduces the risk of hernia recurrence. The use of mesh in patients with strangulated hernias requiring bowel resection is controversial.

Patients and methods: Patients with acutely incarcerated hernias (with small intestine contents) who underwent polypropylene mesh hernioplasty were included in this prospective study from June 2005 to Jan. 2011.

Results: 163 patients were included; 48 required intestinal resection and anastomosis (Group I) and 115 did not (Group II). Operative times and hospital stay were longer in Group I (P = 0.001). No significant difference was noted between both groups in terms of postoperative morbidities (16.6% vs 13% P = 0.5), wound infection (6% vs 4% P = 0.6), and recurrence rate (2% vs 2.8% P = 0.8), All cases of wound infection were successfully managed with drainage and local wound care and no mesh had to be removed. One patient in Group I and five patients in Group II died of concomitant diseases in the follow-up period (P = 0.5).

Conclusion: Mesh hernioplasty is crucial to prevent recurrence, and it is safe to utilize it in repair of acutely incarcerated hernias even if associated with intestinal resection.