Mesh sutured repairs of contaminated incisional hernias

Gregory A. Dumanian*, Steven T. Lanier, Jason M. Souza, Mimi Wu Young, Alexei S. Mlodinow, Anne Marie Boller, Kyle H. Mueller, Amy L. Halverson, Michael F. McGee, Jonah J. Stulberg

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: We sought to evaluate the results of a new mesh sutured repair technique for closure of contaminated incisional hernias. Methods: 48 patients with contaminated hernias 5 cm wide or greater by CT scan were closed with mesh sutures. Surgical site occurrence, infections, and hernia recurrence were compared to similar patient series reported in the literature. Results: Of the 48 patients, 20 had clean-contaminated wounds, 16 had contaminated wounds, and 12 were infected. 69% of the patients underwent an anterior perforator sparing components release for hernias that averaged 10.5 cm transversely (range 5 cm–25 cm). SSO occurred in 27% of patients while SSI was 19%. There were no fistulas or delayed suture sinuses. With a mean follow-up of almost 12 months, 3 midline hernias recurred (6%). In these same patients, three parastomal hernias repaired with mesh sutures failed out of 4 attempted for a total failure rate of 13%. Conclusion: Mesh sutured closure represents a simplified and effective surgical strategy for contaminated midline incisional hernia repair.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalAmerican journal of surgery
Volume216
Issue number2
DOIs
StatePublished - Aug 1 2018

Fingerprint

Hernia
Sutures
Surgical Wound Infection
Herniorrhaphy
Wounds and Injuries
Fistula
Incisional Hernia
Recurrence

ASJC Scopus subject areas

  • Surgery

Cite this

Dumanian, Gregory A. ; Lanier, Steven T. ; Souza, Jason M. ; Young, Mimi Wu ; Mlodinow, Alexei S. ; Boller, Anne Marie ; Mueller, Kyle H. ; Halverson, Amy L. ; McGee, Michael F. ; Stulberg, Jonah J. / Mesh sutured repairs of contaminated incisional hernias. In: American journal of surgery. 2018 ; Vol. 216, No. 2. pp. 267-273.
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Mesh sutured repairs of contaminated incisional hernias. / Dumanian, Gregory A.; Lanier, Steven T.; Souza, Jason M.; Young, Mimi Wu; Mlodinow, Alexei S.; Boller, Anne Marie; Mueller, Kyle H.; Halverson, Amy L.; McGee, Michael F.; Stulberg, Jonah J.

In: American journal of surgery, Vol. 216, No. 2, 01.08.2018, p. 267-273.

Research output: Contribution to journalArticle

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AU - Boller, Anne Marie

AU - Mueller, Kyle H.

AU - Halverson, Amy L.

AU - McGee, Michael F.

AU - Stulberg, Jonah J.

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N2 - Background: We sought to evaluate the results of a new mesh sutured repair technique for closure of contaminated incisional hernias. Methods: 48 patients with contaminated hernias 5 cm wide or greater by CT scan were closed with mesh sutures. Surgical site occurrence, infections, and hernia recurrence were compared to similar patient series reported in the literature. Results: Of the 48 patients, 20 had clean-contaminated wounds, 16 had contaminated wounds, and 12 were infected. 69% of the patients underwent an anterior perforator sparing components release for hernias that averaged 10.5 cm transversely (range 5 cm–25 cm). SSO occurred in 27% of patients while SSI was 19%. There were no fistulas or delayed suture sinuses. With a mean follow-up of almost 12 months, 3 midline hernias recurred (6%). In these same patients, three parastomal hernias repaired with mesh sutures failed out of 4 attempted for a total failure rate of 13%. Conclusion: Mesh sutured closure represents a simplified and effective surgical strategy for contaminated midline incisional hernia repair.

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Dumanian GA, Lanier ST, Souza JM, Young MW, Mlodinow AS, Boller AM et al. Mesh sutured repairs of contaminated incisional hernias. American journal of surgery. 2018 Aug 1;216(2):267-273. https://doi.org/10.1016/j.amjsurg.2017.10.025