Emergency incisional hernia repair: A difficult problem waiting for a solution

Hasnain Zafar, Masooma Zaidi, Irfan Qadir, Ayaz A. Memon

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)

Abstract

Background: Emergency repair of incarcerated incisional hernia with associated bowel obstruction in potentially or contaminated field is technically challenging due to edematous, inflamed and friable tissues with occasional need for concurrent bowel resection and carries high rates of post-operative infectious complications. The aim of this study was to retrospectively assess the wound related morbidity of use of permanent prosthetic mesh in emergency repair of incarcerated incisional hernia with associated bowel obstruction. We also describe a new technique of leaving the mesh exposed to heal by secondary intention with granulation tissue.Methods: Between 2000 and 2010 a total of 60 patients underwent emergency surgery for incarcerated incisional hernia with associated bowel obstruction with placement of permanent prosthetic mesh. The wound was closed after hernia repair in 55 patients while it was left open to granulate in 5 patients.Results: In the group of patients with primary wound closure, 11 patients developed superficial surgical site infection, 5 developed deep wound infection and one patient had cellulitis. These patients were treated with wound debridement and antibiotics. Mesh removal was required in one patient. There were no infections in the group of patients who had their surgical wounds left open. One patient in this group died on the fifth postoperative day from septicemia.Conclusion: Use of permanent prosthetic mesh in emergency repair of incarcerated incisional hernia with associated bowel obstruction. in contaminated field is associated with high risk of wound infection.

Original languageEnglish
Article number1
JournalAnnals of Surgical Innovation and Research
Volume6
DOIs
Publication statusPublished - 4 Jan 2012

Keywords

  • Emergency hernia repair
  • Incisional hernia
  • Obstructed hernia

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