PMID: 24351360Dec 20, 2013Paper

Use of polypropylene mesh in the management of a contaminated large ventral hernia: a contraindication or a solution?

The American Surgeon
Fei Yang

Abstract

Management of contaminated large ventral hernias is still a challenge as a result of massive loss of muscular and fascial tissues in the abdominal wall, traditional contraindication to use of a prosthesis, and complicated perioperative management. This study aimed to provide a solution for this challenging dilemma using monofilament polypropylene mesh (Marlex; Bard) in the Sublay-Bridge fashion. Twenty-three consecutive patients with contaminated large ventral hernias from 2009 to 2011 were identified. Preoperatively, source of contamination at the surgical site was managed through oral antibiotics, wound débridement, and dressing change; the hernia content was reduced into the abdominal cavity gradually and an abdominal binder was applied. Marlex meshes in the Sublay-Bridge fashion were used in these patients. Demographic and perioperative data were collected. Fourteen males and nine females were included with a mean age of 52.5 ± 10.5 years and a mean body mass index of 25.2 ± 6.1 kg/m(2). Twelve patients underwent ostomy takedown, which was the most common indication. Mean hernia size was 120.5 ± 18.5 cm(2) and a mean mesh size was 380.0 ± 80.5 cm(2). The mean operative time was 125.5 ± 35.5 minutes and the hospital stay was...Continue Reading

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