Use of polypropylene prostheses for strangulated inguinal and incisional hernias

Abstract

We used monofilament polypropylene prostheses in 20 emergency operations for strangulated hernias. Sixteen of the operated patients had groin hernias (five of them recurrent), two had incisional and one had a Spigel's type hernia. Intestinal resection was performed because of bowel wall necrosis in one of the patients. During the postoperative period, we observed only one minor complication (a seroma formation). During the follow-up, no recurrence was observed. In our opinion, the use of monofilament polypropylene mesh in emergency hernia operations is safe, simple and effective.

Prosthetic repair of acutely incarcerated groin hernias: a prospective clinical observational cohort study

“…Most surgeons are afraid of wellknown complications that could be associated with foreign material implantation in the setting of incarcerated or strangulated bowel loop. This issue has been studied only in few articles, and either no synthetic material has been used in most of the hernioplasty procedures or very few intestinal resections have been performed in the study groups [1][2][3]. For this reason, we aimed to audit the outcome of acutely incarcerated groin hernias treated by non-absorbable mesh.…”

“…Delving into related literature, there can be seen a few articles regarding herniorrhaphy under emergent conditions. Thus, mesh usage in the presence of intestinal necrosis has not been investigated adequately [1][2][3][4]. This is a crucial issue because the presence of strangulated hernia is a serious clinical condition that is responsible for the significant mortality and requires tension-free and sound repair.…”

WSES guidelines for emergency repair of complicated abdominal wall hernias

“…Researchers have published a variety of small-scale studies comparing mesh use to suture repair in the treatment of acute irreducible hernias [43-46]. In 2011, Nieuwenhuizen et al published a retrospective study investigating the use of mesh in acute hernia-related procedures.…”

Comparison of prosthetic mesh repair and tissue repair in the emergency management of incarcerated para-umbilical hernia.

“…Second, using a prosthetic substance like prolene mesh as an onlay patch in the emergency treatment of the incarcerated PUH is risk-free, simple to carry out, and not linked to significant systemic or mesh-related problems. Finally, as previously demonstrated by others [12][13][14][15] , intestinal ischemia or necrosis, and subsequent need for the intestinal resection may not be considered contra indications for the mesh repair.…”

“…Some studies have shown that prosthetic repair for incarcerated PUH in the emergency settings have yielded good outcomes. [11][12][13][14][15][16] Pre-peritoneal prosthetic mesh was inserted successfully into 35 patients with strangulated groin hernias by Pans et al 12 Polypropylene meshes was used successfully by Wysocki et al to treat strangulated inguinal and incisional hernias. 14 Patients received Lichtenstein treatment for incarcerated groin hernias in a later report by the same group.…”