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World Journal of Surgery

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01-07-2012

Intraperitoneal Mesh Implantation for Fascial Dehiscence and Open Abdomen

Authors: Moritz Scholtes, Anita Kurmann, Christian A. Seiler, Daniel Candinas, Guido Beldi

Published in: World Journal of Surgery | Issue 7/2012

Abstract

Background

Postoperative fascial dehiscence and open abdomen are severe postoperative complications and are associated with surgical site infections, fistula, and hernia formation at long-term follow-up. This study was designed to investigate whether intraperitoneal implantation of a composite prosthetic mesh is feasible and safe.

Methods

A total of 114 patients with postoperative fascial dehiscence and open abdomen who had undergone surgery between 2001 and 2009 were analyzed retrospectively. Contaminated (wound class 3) or dirty wounds (wound class 4) were present in all patients. A polypropylene-based composite mesh was implanted intraperitoneally in 51 patients, and in 63 patients the abdominal wall was closed without mesh implantation. The primary endpoint was incidence of incisional hernia, and the incidence of enterocutaneous fistula was a secondary endpoint.

Results

The incidence of enterocutaneous fistulas after wound closure post-fascial dehiscence (13% vs. 6% without and with mesh, respectively) or post-open abdomen (22% vs. 28% without and with mesh, respectively) was not significantly different. The incidence of incisional hernia was significantly lower with mesh implantation compared with no-mesh implantation in both contaminated (4% vs. 28%; p = 0.025) and dirty abdominal cavities (5% vs. 34%; p = 0.01).

Conclusions

Intra-abdominal contamination is not a contraindication for intra-abdominal mesh implantation. The incidence of enterocutaneous fistula is not elevated despite the presence of contamination. The rate of incisional hernias is significantly reduced after intraperitoneal mesh implantation for postoperative fascial dehiscence or open abdomen.

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Title: Intraperitoneal Mesh Implantation for Fascial Dehiscence and Open Abdomen
Authors: Moritz Scholtes
Anita Kurmann
Christian A. Seiler
Daniel Candinas
Guido Beldi
Publication date: 01-07-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 7/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1534-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intraperitoneal Mesh Implantation for Fascial Dehiscence and Open Abdomen

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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