Department of General Surgery, Faculty of Medicine, Cumhuriyet University, Sivas, 58140, Turkey,
Surg Today. 2013 Oct;43(10):1140-4. doi: 10.1007/s00595-012-0397-0. Epub 2012 Nov 7.
There is a common doubt regarding the application of polypropylene mesh to treat incarcerated and strangulated hernias due to the possibility of surgical site infection. We aimed to investigate the results of mesh repair of incarcerated and strangulated hernias, and to evaluate the incidence of wound infection and recurrence.
One hundred and fifty-three consecutive patients with incarcerated and strangulated hernias underwent surgery with mesh repair. The patients were divided into two groups: a resection group and a nonresection group. Fisher's exact test, the Chi-square test and independent samples t test were used to determine the statistical significance level (p < 0.05).
While 53 patients required organ resection, the remaining 100 patients did not. The most frequently incarcerated organs were the omentum (86), small bowel (74) and colon (15). Most of the resections were performed in the omentum (36), small bowel (23) and colon (2). While five of the 53 patients (9.4%) in the resection group developed wound infections, no infections were observed in the nonresection group (p = 0.004). The infection rate in all patients was 3.3% (five of 153 patients). None of the infected patients required mesh removal. There were no mortalities or recurrence in either group.
The findings revealed effective and safe usage of mesh along with antibiotic therapy in patients undergoing incarcerated and strangulated hernia repair.
由于发生手术部位感染的可能性,在治疗嵌顿和绞窄性疝时应用聚丙烯网片存在普遍的疑虑。我们旨在研究网片修补嵌顿和绞窄性疝的结果,并评估伤口感染和复发的发生率。
153 例连续的嵌顿和绞窄性疝患者接受了网片修补手术。患者被分为两组:切除组和非切除组。Fisher 确切检验、卡方检验和独立样本 t 检验用于确定统计学显著性水平(p<0.05)。
53 例患者需要进行器官切除,其余 100 例患者不需要。最常发生嵌顿的器官是网膜(86 例)、小肠(74 例)和结肠(15 例)。大多数切除发生在网膜(36 例)、小肠(23 例)和结肠(2 例)。在切除组的 53 例患者中有 5 例(9.4%)发生了伤口感染,而非切除组未发生感染(p=0.004)。所有患者的感染率为 3.3%(153 例患者中有 5 例)。没有感染的患者需要取出网片。两组均无死亡或复发。
研究结果表明,在接受嵌顿和绞窄性疝修补术的患者中,使用网片联合抗生素治疗是有效且安全的。