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Outcome of the Use of a Synthetic Mesh in the Repair of Burst Abdomen as Compared with Simple Suture
Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
Servicio de Cirugía General y Digestiva, Hospital del Mar, Parc de Salut Mar, Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain
Servicio de Cirugía General y Digestiva, Hospital de Igualada, Barcelona, Spain
Servicio de Cirugía General y Digestiva, Hospital del Mar, Parc de Salut Mar, Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain
Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- 1 Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- 2 Servicio de Cirugía General y Digestiva, Hospital del Mar, Parc de Salut Mar, Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain
- 3 Servicio de Cirugía General y Digestiva, Hospital de Igualada, Barcelona, Spain
- 4 Servicio de Cirugía General y Digestiva, Hospital del Mar, Parc de Salut Mar, Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain
- 5 Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- 6 Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- 7 Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- 8 Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General y Digestiva, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
International Journal of Clinical Medicine·Volume 06 (2015)·Pages 113–118·Published 10 March 2015·DOI10.4236/ijcm.2015.63016
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Abstract
Aim: To assess the outcome (postoperative morbidity and mortality and/or development of incisional hernia) of patients with burst abdomen (BA) of midline laparotomy without intestinal fistula comparing early closure of the abdominal wall with a running suture alone vs. running suture plus reinforcement with a non-absorbable synthetic mesh. Methods: Retrospective analysis of the medical records of all patients undergoing surgical repair of a BA in three hospitals between 2006 and 2011. Risk factors, postoperative complications and the incidence of incisional hernia (IH) after a minimum of 12-month follow-up period were compared between groups. Results: A total of 109 patients were treated for BA, 18 patients treated by non-standard procedures were excluded from analysis. Of the remaining 91 patients, 56 belong to the mesh group and 35 to the suture group. The overall rate of postoperative complications was high in both groups (79.1%). Mortality rate was higher in the suture group than in the mesh group (31.4% vs. 14.3%; P = 0.06). IH was also more frequent in the suture group (36.4% vs. 17.6%; P = 0.057). Conclusions: Patients with BA and without intestinal fistula could be candidates for surgical repair using a running suture and a non-absorbable polypropylene mesh in the “onlay” position.
KeywordsMeshSutureBurst AbdomenAbdominal WallHernia
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