, Volume 8, Issue 3, pp 190–192 | Cite as

Prosthetic repair, intestinal resection, and potentially contaminated areas: Safe and feasible?

  • G. CampanelliEmail author
  • F. M. Nicolosi
  • D. Pettinari
  • E. Contessini Avesani
Original Article



Prosthetic repair for abdominal wall hernia currently represents the gold standard. However, it is still difficult to identify the correct indication for prosthetic implant in borderline cases. The authors propose evaluating whether a prosthetic implant is absolutely contraindicated in potentially infected operating fields through the review of literature and personal experience.

Materials and methods

The authors performed ten prosthetic hernia repairs in potentially contaminated areas, with a preliminary preparation of the retromuscular-preperitoneal space hosting the prosthesis implant, and subsequent performance of the major operation.


There were neither major nor minor complications with a 21-month follow-up (mean period).


It is certain that both in noncomplicated inguinal hernia and in abdominal wall hernia repairs, the use of antibiotics can significantly reduce the number of infections. It is very important to underline that the success of the described procedure can be guaranteed only by an accurate preparation of the preperitoneal space: perfect haemostasis, temporary closure of the space with the insertion of iodine gauzes and suturing the edges, local antibiotic treatment, washing of the cavity, and accurate drainage.


Prosthetic repair is the gold standard for inguinal, incisional, and all abdominal wall hernias and should be used, with the method described, even in potentially contaminated areas. The use of a prosthesis has to be avoided in clearly infected cases.


Prosthetic repair Mesh Contaminated fields Intestinal resection Correct implantation 


  1. 1.
    Birolini C, Utiyama EM, Rodrigues AJ Jr, Birolini D (2000) Elective colonic operation and prosthetic repair of incisional hernia: does contamination contraindicate abdominal wall prosthesis use? J Am Coll Surg 191:366–372CrossRefPubMedGoogle Scholar
  2. 2.
    Pans A, Deasive C, Jacquet N (1997) Use of preperitoneal prosthesis for strangulated groin hernia. Br J Surg 84:310–312CrossRefPubMedGoogle Scholar
  3. 3.
    Wysocki A, Pozniczek M, Krzywon J, Bolt L (2001) Use of polypropylene prostheses for strangulated inguinal and incisional hernias. Hernia 5:105–106CrossRefPubMedGoogle Scholar
  4. 4.
    Sarli L, Villa F, Marchesi F (2001) Hernioplasty and simultaneous laparoscopic cholecystectomy: a prospective randomized study of open tension-free versus laparoscopic inguinal hernia repair. Surgery 129:530–536Google Scholar
  5. 5.
    Pans A, Plumacker A, Legrand M, Mohad F, Dubois J, Meurisse M, Honore P, Desaive C, Jacquet N (1991) Surgical treatment of incarcerated inguino-crural hernia with interposition of a polypropylene prosthesis. Acta Chir Belg 91:223–226PubMedGoogle Scholar
  6. 6.
    Tekkis PP, Kocher HM, Payne JG (1999) Parastomal hernia repair: modified thorlakson technique, reinforced by polypropylene mesh. Dis Colon Rectum 42:1505–1508PubMedGoogle Scholar
  7. 7.
    Rios A, Rodriguez JM, Munitiz V, Alcaraz P, Perez Flores D, Parrilla P (2001) Antibiotic prophylaxis in incisional hernia repair using a prosthesis. Hernia 5:148–152PubMedGoogle Scholar
  8. 8.
    Gervino L, Cangioni G, Renzi F (2000) A retrospective study on the efficacy of short-term perioperative prophylaxis in abdominal wall surgery for hernia repair in 1,254 patients. J Chemother 12 Suppl 3:34–37Google Scholar
  9. 9.
    Yerderl MA, Akin EB, Dolalan S, Turkcapar AG, Pehlivan M, Gecim IE, Kuterdem E (2001) Effect of single dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh: the randomized, double blind, prospective trial. Ann Surg 233:26–33PubMedGoogle Scholar
  10. 10.
    Franklin ME Jr, Gonzalez JJ Jr, Michaelson RP, Glass JL, Chock DA (2002) Preliminary experience with new bioactive prosthetic material for repair of hernias in infected fields. Hernia 6:171–174CrossRefPubMedGoogle Scholar
  11. 11.
    Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans NJ, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijnickx CM, Jeekel J (2000) Comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398PubMedGoogle Scholar
  12. 12.
    Vrijland WW, van den Tol MP, Luijendijk RW, Hop WC, Busschback JJ de Lange DC, van Geldere D, Rottier AB, Vegt PA, IJzermans NJ, Jeekel J (2002) Randomized clinical trial of non mesh versus mesh repair of primary inguinal hernia. Br J Surg 89:293–297CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • G. Campanelli
    • 1
    Email author
  • F. M. Nicolosi
    • 1
  • D. Pettinari
    • 1
  • E. Contessini Avesani
    • 1
  1. 1.Department of Surgical Sciences Pad. Beretta Est Ospedale Maggiore di MilanoUniversity of MilanoMilanoItaly

Personalised recommendations