Use of expanded polytetrafluoroethylene in the repair of the difficult hernia.

Hernias that are not correctable by primary approximation require a prosthetic material to provide a tension-free repair. We report the results of 121 consecutive ventral (40) and inguinal (81) herniorrhaphies in 112 patients using the 2.0-mm expanded polytetrafluoroethylene (ePTFE) soft tissue patch. All follow-up was conducted by physical examination by the surgical team. Average follow-up was 49 months. Five patients (4%) experienced complications: there was 1 inguinal recurrence, 1 ventral recurrence, 1 seroma, 1 wound infection, and 1 prolonged gastrocutaneous fistula. The cause of one of the recurrences is unknown because the patient refused further surgery. The seroma resolved spontaneously after two aspirations. The remaining three complications were considered to be unrelated to the implantation of the prosthetic patch. There were no complications due to adhesions, bowel erosion, or bowel obstruction in the ventral repairs. On the basis of our clinical experience, we believe that ePTFE is an acceptable mode of treatment for all difficult hernias.