>Year 2004, Issue 4
Mayagoitia GJC, López HJA, Suárez FD, Cisneros MHA
Transcutaneous fixation of the mesh in incisional hernioplasty to diminish early complications
Cir Gen 2004; 26 (4)
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Objective: To compare two types of mesh fixation at the time of performing an incisional or ventral hernia repair with the Rives’ procedure.
Setting: Private specialized medical institution.
Design: Comparative, retrospective non-randomized study.
Patients and method: We studied two groups of patients subjected to surgery to repair incisional or ventral hernias: Group A, using a trans-aponeurotic fixation and Group B, using a trans-cutaneous fixation. The investigated variables were: age, primary or recurring hernia, infection in previous surgeries, incarcerated or not, comorbidity, body mass index, hospital stay days, and complications during the first year after surgery.
Statistical analysis: Descriptive and analytical statistics, using χ2 for qualitative variables and Wilcoxon’s test for quantitative variables.
Results: There were 83 (Group A) and 52 (Group B) patients; 60 (72.2%) women in Group A and 43 (82.7%) in group B, average age of 53 and 52, respectively. Primary hernia were 48 (57.8%) and 24 (46.2%); recurring, 35 (42.2%) and 28 (53.8%); infection in some previous surgery, 21 (25.3%) and 8 (15.4%); incarcerated, 31 (37-3%) and 17 (32.7%). There were 16 complications (19.3%) in group A and 5 (9.6%) in group B without statistical significance χ2 = 1.59 (p = 0.20). Seven patients from group A presented seromas (8.4%) and three from group B (5.8%) with p = 0.24. In group A, one patient coursed with hematoma, another with chronic pain, and three with abdominal movement restriction, whereas none in group B.
Conclusion: Despite the apparent advantages of lesser mobilization of the skin grafts, there was no advantage in using trans-cutaneous suture points in the fixation of the mesh in the incisional hernia repairs in this study.
||Abdominal wall, incisional hernia, hernioplasty, mesh, morbidity.
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>Year 2004, Issue 4