EMERGENCY INCISIONAL HERNIA REPAIR IN TERMS OF MORTALITY, MORBIDITY AND SURGICAL OUTCOMES.

Abstract

Background:

Emergency hernia repair is technically very challenging and involves a very high risk of post-operative infectious complications in case of incarcerated incisional hernias in association with bowel obstruction which is due to its edematous, inflammatory, and friable tissues. The study's prime objective was to prospectively assess the wound-related morbidity in using permanent prosthetic mesh in an emergency laparotomy of an incarcerated incisional hernia with a corresponding intestinal obstruction. We also go over a novel method of leaving the mesh exposed for the formation of granulation tissue.

Methods:

Emergency laparotomy was performed on sixty patients with incarcerated incisional hernias associated with intestinal obstructions to place the permanent prosthetic mesh. In fifty-three patients hernia was repaired and the wound was sutured, but in seven individuals, it was left open to granulate.

Results:

9 patients had superficial surgical site infections, 3 had deep wound infections, and 2 patients suffered from cellulitis which was seen in the group of patients where the wound was closed primarily. These patients underwent both wound debridement and antibiotics were administered. 2 patients required the removal of the mesh placed. In the group of patients who had their surgical wounds left exposed, there were no infections. On the 7^th postoperative day, a patient in this group passed away from septicemia.

Conclusion:

In obstructed incisional hernia patient who was treated in emergency with permanent prosthetic mesh the wound infection was quite high on a contaminated field.