Skip to main content
Log in

Polypropylene mesh repair of incarcerated and strangulated hernias: a prospective clinical study

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

There is a common doubt regarding the application of polypropylene mesh to treat incarcerated and strangulated hernias due to the possibility of surgical site infection. We aimed to investigate the results of mesh repair of incarcerated and strangulated hernias, and to evaluate the incidence of wound infection and recurrence.

Methods

One hundred and fifty-three consecutive patients with incarcerated and strangulated hernias underwent surgery with mesh repair. The patients were divided into two groups: a resection group and a nonresection group. Fisher’s exact test, the Chi-square test and independent samples t test were used to determine the statistical significance level (p < 0.05).

Results

While 53 patients required organ resection, the remaining 100 patients did not. The most frequently incarcerated organs were the omentum (86), small bowel (74) and colon (15). Most of the resections were performed in the omentum (36), small bowel (23) and colon (2). While five of the 53 patients (9.4 %) in the resection group developed wound infections, no infections were observed in the nonresection group (p = 0.004). The infection rate in all patients was 3.3 % (five of 153 patients). None of the infected patients required mesh removal. There were no mortalities or recurrence in either group.

Conclusions

The findings revealed effective and safe usage of mesh along with antibiotic therapy in patients undergoing incarcerated and strangulated hernia repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Catena F, La Donna M, Gagliardi S, Mingolla P, Avanzolini A, Pasqualini E, et al. Use of prosthetic mesh in complicated incisional hernias. Minerva Chir. 2002;57:363–9.

    PubMed  CAS  Google Scholar 

  2. Henry X, Randiamanantsoa V, Verhaeghe P, Stoppa R. Is there a reasonable role for prosthetic materials in the emergency treatment of hernias? Chirurgie. 1994;120:117–20.

    Google Scholar 

  3. Mauch J, Helbling C, Schlumpf R. Incarcerated and strangulated hernias-surgical approach and management. Swiss Surg. 2000;6:28–31.

    Article  PubMed  CAS  Google Scholar 

  4. Wysocki A, Pozniczek M, Krzywon J, Bolt L. Use of polypropylene prostheses for strangulated inguinal and incisional hernias. Hernia. 2001;5:105–6.

    Article  PubMed  CAS  Google Scholar 

  5. Arabamson J. Hernias. In: Zinner MJ, Schwartz SI, Ellis H, editors. Maingot’s Abdominal Operations. Englewood Cliffs: Prentice-Hall; 1997. p. 479–80.

    Google Scholar 

  6. Citgez B, Yetkin G, Uludag M, Karakoc S, Akgun I, Ozsahin H. Littre’s hernia, an incarcerated ventral incisional hernia containing a strangulated meckel diverticulum: report of a case. Surg Today. 2011;4:576–8.

    Article  Google Scholar 

  7. Yerdel MA, Akin EB, Dolalan S, Turkcapar AG, Pehlivan M, Gecim IE, et al. Effects of single-dose prophlactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polyporpylene mesh. The randomized, double-blind, prospective trial. Ann Surg. 2001;233:26–33.

    Article  PubMed  CAS  Google Scholar 

  8. Abdel-Baki NA, Bessa SS, Abdel-Razek AH. Comparison of prosthetic mesh repair and tissue repair in the emergency management of incarcerated para-umblical hernia: a prospective randomized study. Hernia. 2007;11:163–7.

    Article  PubMed  CAS  Google Scholar 

  9. Atila K, Guler S, Inal A, Sokmen S, Karademir S, Bora S. Prosthetic repair of acutely incarcerated groin hernias: a prospective clinical observational cohort study. Langenbecks Arch Surg. 2010;395:563–8.

    Article  PubMed  Google Scholar 

  10. Papaziogas B, Lazaridis CH, Makris J, Koutelidakis J, Patsas A, Grigoriou M, et al. Tension-free repair versus modified Bassini technique (Andrews technique) for strangulated inguinal hernia: a comparative study. Hernia. 2005;9:156–9.

    Article  PubMed  CAS  Google Scholar 

  11. Bessa SS, Katri KM, Abdel-Salam WN, Abdel-Baki NA. Early results from the use of the Lichtenstein repair in the managment of strangulated groin hernia. Hernia. 2007;11:239–42.

    Article  PubMed  CAS  Google Scholar 

  12. Derici H, Unalp HR, Nazli O, Kamer E, Coskun M, Tansug T, et al. Prosthetic repair of in incarcerated inguinal hernias: is it a reliable method? Langenbecks Arch Surg. 2010;395:575–9.

    Article  PubMed  Google Scholar 

  13. Wysocki A, Kulawik J, Pozniczek M, Strzalka M. Is the Lichtenstein operation of strangulated groin hernia a safe procedure? World J Surg. 2006;30:2065–70.

    Article  PubMed  Google Scholar 

  14. Pans A, Desaive C, Jaquet N. Use of a preperitoneal prosthesis for strangulated groin hernia. Br J Surg. 1997;84:310–2.

    Article  PubMed  CAS  Google Scholar 

  15. Karatepe O, Adas G, Battal M, Gulcicek OB, Polat Y, Altiok M, et al. The comparison of preperitoneal and Lichtenstein repair for incarcerated groin hernias: a randomised controlled trial. Int J Surg. 2008;6:189–92.

    Article  PubMed  Google Scholar 

  16. Sanabria A, Domínguez LC, Valdivieso E, Gómez G. Prophylactic antibiotics for mesh inguinal hernioplasty: a meta-analysis. Ann Surg. 2007;245:392–6.

    Article  PubMed  Google Scholar 

  17. Glassow F. Is postoperative wound infection following simple inguinal herniorraphy a predisposing cause for recurrent hernia? Can Med Assoc J. 1964;91:870–1.

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to O. Topcu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Topcu, O., Kurt, A., Soylu, S. et al. Polypropylene mesh repair of incarcerated and strangulated hernias: a prospective clinical study. Surg Today 43, 1140–1144 (2013). https://doi.org/10.1007/s00595-012-0397-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-012-0397-0

Keywords

Navigation