Outcome of Synthetic Mesh Repair in Open Incisional Ventral Hernia Repair in Patients With Comorbidities

Abstract

BACKGROUND: The VHWG recommend synthetic mesh in Grade I, biologic mesh in Grade III and Grade IV. The use of synthetic mesh in Grade II comrbid patient is matter of consideration and debate. Our aim was to examine the outcome of synthetic mesh repair in open incisional ventral hernia repair in patients with comorbidities. METHODS: Retrospective review of all open, grade II VHR performed by single surgeon over 5 years was evaluated. RESULTS: Seventysix patients with grade II ventral hernia underwent open hernia repair with synthetic mesh during the study period. There were 40 males and 36 females in our study with mean age of 53 years (range 30-85). Comorbidities associated with these patients included obesity in 43 (56%), smoking in 25 (32%), COPD in 19 (25%), diabetes milletus in 32 (42%), and immunosuppression in 2 (2.6%). Surgical site occurrence as defined by VHWG was identified in 12 (16%) patients which included 8 (10%) surgical site infection (SSIs), 3 (4%) seroma and 1 (1%) wound dehiscence. One patient developed recurrence during the follow-up period. CONCLUSION: Synthetic macroporous mesh can be used in co morbid patients with no long term complications with recurrence of less than 1.3%. although surgical site occurrence in this cohort of patients is high (16%), they can be managed conservatively with antibiotics.