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Synthetic mesh repair for incisional hernia treatment in high-risk patients for surgical site occurrences.

Köhler, Gernot, Weitzendorfer, Michael, Kalcher, Veronika and Emmanuel, Klaus (2015) Synthetic mesh repair for incisional hernia treatment in high-risk patients for surgical site occurrences. [Fachpublikation (peer reviewed)]

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Abstract

Patients with incisional hernias (IH) and risk factors for surgical site occurrences (SSOs) such as defined comorbidities and/or potential contaminations are considered to be treated with bioprosthetics. A retrospective analysis of consecutive patients who had undergone elective IH repair with synthetic mesh materials between 2009 and 2013 was conducted. Only patients who were classified into Grades II and III according to the classification of the Ventral Hernia Working Group (VHWG) were considered for the study. Primary outcome parameter was the incidence of SSO. The relationships among demographics, hernia characteristics, surgical technique, and SSOs were also evaluated. Overall, 108 patients were included (Grade II: 68, Grade III: 40). SSO was identified in 14 patients. Having two or more comorbidities (P = 0.04), an open sublay technique (P = 0.005), duration of operation (P = 0.02), larger hernia defects (P = 0.001), and using larger mesh sizes (P = 0.01) were associated with significantly higher rates of SSO. Affiliation to VHWG Grading II or III showed no impact on SSO occurrence. Synthetic mesh repair both in an "open sublay" and laparoscopic intraperitoneal technique is safe regarding patients with risk factors for SSO. The recommendations of the VHWG must be declined and a modification of the grading system is warranted overlooking a more liberal use of synthetic meshes.
Item Type: Fachpublikation (peer reviewed)
Divisions: Ordensklinikum Linz Barmherzige Schwestern > Allgemeinchirurgie mit Viszeralchirurgie
Depositing User: Manuela Schühler
Date Deposited: 08 Mar 2021 09:01
Last Modified: 08 Mar 2021 09:01
URI: http://eprints.vinzenzgruppe.at/id/eprint/8052

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