Cisneros MHA

Language: Spanish
References: 13
Page: 275-279
PDF size: 46.72 Kb.

ABSTRACT

Objective:To demonstrate that the monofilamentous, macroporose, heavy, polypropylene mesh can be re-sterilized with 100% ethylene oxide without undergoing changes in its physical characteristics and can be used safely.
Setting:High Specialty Medical Unit.
Design:Prospective, longitudinal comparative study.
Statistical analysis:Descriptive statistics and Fisher’s test.
Material and methods:The study included 60 patients, older than 15 years and of either gender, operated under epidural anesthesia by the same surgeon from November 2000 to November 2004. Patients were randomly divided in two groups: Group A, new mesh (n = 30). Group B, re-sterilized mesh (n = 30). Analyzed variables were: age, gender, site of the hernia, aggregated diseases, hernia classification, surgical time, hospital stay, early and late complications, and recurrences as well as the use of drainages and/or antibiotics. We used the Gilbert/Rutkow classification. Follow-up at 7-14 and 30 days, 6-12-24-36, 48 months.
Results:Sixty three inguinal repairs in 60 patients (3 bilateral), handled ambulatory, 54 men (85.7%) and 9 women (14.3%), age range 19 to 90 years. All were primary hernias. No drainages or antibiotics were used. No recurrences or infections occurred. Complications consisted of seroma in one case and disesthesia in another. There were no cases of disabling inguinodynia. No differences existed between groups.
Conclusions:The polypropylene mesh can be re-sterilized with 100% ethylene oxide without altering its physical properties and does not increase the incidence of infections or recurrences.

REFERENCES

1. Rutkow IM. Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am 1998; 78: 941-51, v-vi.

2. Read RC. Cigarette smoking, herniation, and recurrence. Surgery 1998; 124: 942.

3. Amid PK. Lichtenstein tension – free hernioplasty: its inception, evolution and principles. Hernia 2004; 8: 1-7.

4. Read RC. Milestones in the history of hernia surgery: Prosthetic repair. Hernia 2004; 8: 8-14.

5. Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg 1989; 157: 188-193.

6. Amid PK. Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1997; 1: 15-21.

7. Gilbert AI. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia. Am J Surg 1989; 157: 331-333.

8. Cisneros MHA, Mayagoitia GJC, Suárez FD. Hernioplastía Inguinal Híbrida libre de tensión de “Cisneros”. ¿La mejor opción para evitar recurrencias? Cir Gen 2003; 25: 163-168.

9. Robbins AW, Rutkow IM. The mesh-plug hernioplasty. Surg Clin North Am 1993; 73: 501-512.

10. Cisneros MHA, Mayagoitia GJC, Suárez FD. Hernioplastía inguinal libre de tensión con técnica de “mesh-plug”. Cir Gen 2001; 23: 21-4.

11. Trabucco E, Trabucco FA. Tension-free sutureless, preshaped mesh hernioplasty In: Nyhus LM, Condon RE (eds). Hernia. 5th ed. Philadelphia, Lippincott, Williams & Wilkins, 2002.

12. Adler RH. An evaluation of surgical mesh in the repair of hernias and tissue defects. Arch Surg 1962;85:836-44.

13. Bracco P, Brunella V, Trossarelli L, Coda A, Botto-Micca F. Comparison of Polypropylene and polyethylene Terephthalate (Dacron) meshes for abdominal wall hernia repair: a chemical and morphological study. Hernia 2005; 9: 51-55.