SURGICAL TREATMENT OF INCISIONAL VENTRAL HERNIAS OF GREAT SIZES USING POLYPROPYLENE MESH MODIFIED BY CARBON NANOTUBES AND AN ANTISEPTIC
In surgical treatment of incisional ventral hernia (IVH) of great sizes, modified surgical technique Ramirez in combination with alloplasty using polypropylene mesh, buth this is accompanied by a fairly high freguency of postoperative complications from the postoperative wound. In our view, the use...
| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Ukrainian Medical Stomatological Academy
2019-04-01
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| Series: | Вісник проблем біології і медицини |
| Subjects: | |
| Online Access: | https://vpbm.com.ua/upload/2019-2-1/37-min.pdf |
| Summary: | In surgical treatment of incisional ventral hernia (IVH) of great sizes, modified surgical technique Ramirez
in combination with alloplasty using polypropylene mesh, buth this is accompanied by a fairly high freguency of
postoperative complications from the postoperative wound.
In our view, the use of a polypropylene mesh modified by carbon nanotubes and an antiseptic of
polyhexamethleneguanidme chloride in combination with the surgical technique Ramirez will improve the results
of surgical treatment of IVH.
Aim to improve the results of surgical treatment of incisional ventral hernias of great proportions by using the
surgical technique Ramirez in alloplasty «sublay» in combination with modified polypropylene mesh.
Object and methods. The analysis of surgical treatment of 164 patients with IVH of great sizes has been performed.
Depending on the type of mesh used during surgical treatment, patients were divided into 2 groups. In 82 (50%) of
Group I patients, the component surgical technique Ramirez in combination with the «sublay» aloplasty with the
use of a modified polypropylene mesh. In the 2nd group, 82 (50%) patients used the component surgical technique
Ramirez in combination with the «sublay» aloplasty with the use of a classic polypropylene mesh.
Results and discussion. Statistically significant results were obtained in patients of Group I compared to Group II:
seroma was in 25 (30.5±1.2%) in Group II compared to 6 (7.3±0.5%) in Group I (p<0.05),respectively, the suppuration
of the postoperative wound 8 (9.8±0.5%) to 1 (1.2±0.2%) (p<0.05). The terms of stay of patients of group II on
inpatient treatment 12±2,2 days group II 7±1 days.
Long-term results: ligature fistulas of the anterior abdominal wall were detected in 5 (6.7±0.5%) patients of
group II, in patients of group I of the ligature fistulas were not detected (p<0.05), meshoma in 3 (4±0.3%) of
patients in group II, in group I there was no stir (p>0.05). Chronic pain in the abdominal wall in 6 8 months after
surgery was observed in 6 (8±0.6)% patients in group II and in 1 (1.3±0.2%) group I (p>0.05), recurrences of hernia
were found in 7 (9.3±0.6%) patients of group II, in group I in 1 (1.3±0.2)% (p<0.05).
Conclusion. Surgical treatment of IVH of great size using the component surgical technique Ramirez in combination
with the «sublay» aloplasty with the use of a modified polypropylene mesh is more effective compared with the use
of the classical polypropylene mesh, namely, reducing the freguency of seroma from 30.5±1.2% in the II group of
patients to 7.3±0.5% in group I, respectively, suppurations of postoperative wounds from 9.8±0.5% to 1.2±0.2%,
inflammatory infiltrates from 12.2±0.6% to 1.2±0.2%, ligaturial fistulas of the anterior abdominal wall from
6.7±0.5% to 0%, meshoma from 4±0.3% to 0%, chronic postoperative pain from 8±0.6% to 1.3±0.2%, recurrence
of hernia from 9.3±0.6% to 1.3±0.2%. |
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| ISSN: | 2077-4214 2523-4110 |