2016, Number 1
Grade 2 complex incisional hernia repair with components separation and reinforcement with synthetic mesh or rectus muscle plication
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ABSTRACTPatients with large or lateral incisional hernias in the presence of comorbidities associated with increased risk of surgical-site infection in the context of a clean surgery are considered Ventral Hernia Working Group grade 2 complex hernias. The purpose of this study is to evaluate post-surgery morbidity and recurrence rates in patients when undergoing reconstruction with components separation and reinforcement technique. There were 19 patients treated during a 5-year period. All of them underwent reconstruction with the components separation technique. Eleven of them had reinforcement with a synthetic mesh, and 8 had rectus muscle plication. Group differences were studied with Fisher’s exact test or Mann-Whitney’s U, depending on the type of variable studied. Post-surgery morbidity was 21%, while 1-year recurrence-free survival was 95%. There was a trend towards a lower complication rate with the perforator-preserving components separation technique. Recurrence rates tended to be lower with synthetic mesh as the reinforcement method. We conclude that complex incisional hernia treatment tend to be less morbid and less recurrent when some perforators are preserved and synthetic mesh is used as a reinforcement method.
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