Medical treatment of hernia of abdomen wall with the use of different plastic materials


  • S. D. Khimich National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • M. D. Zheliba National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • A. I. Reva
  • A. V. Funikov National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • A. P. Prevar National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • A. M. Formanchuk
  • O. V. Katelian
  • V. P. Rautskis
Keywords: hernia, operative medical treatment, autodermal plastic, obesity

Abstract

The purpose of the work is to analyze the results of surgical treatment of hernias using different methods of hernioplasty. The results of treatment of 176 patients with abdominal hernias, which were monitored from 1995 to 2008, were analyzed. Patients were divided into 2 groups. The first group (85 patients) included patients who underwent surgical treatment with autodermal plasty. Second group (91 patients) consisted of patients who underwent hernioplasty using mesh allografts. All patients were comprehensively examined. In obese patients, an antimicrobial film was used to glue the skin under the mammary glands and “folds of the abdomen” to prevent microbial contamination of the wound. All operated patients had a normal postoperative condition, and the postoperative period in both groups was almost the same. We did not observe complications from the side of the postoperative wound in patients of the 1st group. The wounds healed by primary intention. All patients were discharged on the 8–10 day in satisfactory condition. 2 relapses were noted: in one patient 1 month after surgery, in the second — 10 years after surgery. In the 2nd group, suppuration of the postoperative wound was observed in a patient with a II degree of obesity. The average number of bed-days in the 2nd group was approximately the same as in the 1st group. The number of bed-days statistically significantly increased with an increase in the degree of obesity in these patients. Thus, the use of mesh allografts is an effective method of treating hernias and they should be used strictly according to indications. Autodermal plastic surgery using a skin flap is also a reliable surgical method for the treatment of hernias. A significant difference in the indices in the treatment of patients of both groups (with the exception of the cost of mesh allografts) was not found.

References

1. Botezatu, A. A., Marakuca, E. V. & Monul, S. G. (2016). Kombinirovannaya gernioplastika pri pupochnyh gryzhah [Combined hernioplasty for umbilical hernias]. Plasticheskaya hirurgiya segodnya i zavtra [Plastic surgery today and tomorrow], Mater. nauch.-prakt. konf. s mezhdunar. uchastiem. Tiraspol.

2. Vorovskyi, O. O., Shaprynskyi, V. O., & Yatskov, D. A. (2018). Khirurhichne likuvannia defektiv cherevnoi stinky u khvorykh ozhyrinniam [Surgical treatment of abdominal wall defects in patients with obesity]. Kharkivska khirurhichna shkola – Kharkov Surgical School, 2 (89), 156–160.

3. Volkov, V. V., Karashurov, S. E., Karashurov, E. S., Vanyukov, A. V., & Kim, V. Yu. (2001). Gernioplastika autodermalnym loskutom pri recidivnyh i posleoperacionnyh gryzhah [Hernioplasty with an autodermal flap in case of recurrent and postoperative hernias]. Hirurgiya im. N.I. Pirogova – Surgery them. N.I. Pirogov, 8, 37–40. Retrieved from http://www.fesmu.ru/elib/Article.aspx?id=64112.

4. Kovtun, T. T., & Akperov, I. A. (2002). K voprosu o vybore sposoba gernioplastiki pri bolshih i gigantskih sredinnyh gryzhah [To the question of the choice of hernioplasty method for large and giant median hernias]. Problemy mediciny i zdravoohraneniya PMR: proshloe, budushee i nastoyashee – Problems of medicine and health care PMR: past, future and present. Vyp. 1. Tiraspol.

5. Lagutin, D. A., Cherpovodskij, G. M., & Moliboshko, V. P. (2005). Opyt primeneniya transpozicii pryamyh myshc zhivota s autodermalnoj plastikoj v hirurgicheskom lechenii bolshih i gigantskih sredinnyh posleoperacionnyh gryzh [The experience of using transposition of rectus abdominis muscles with autodermal plasty in surgical treatment of large and giant median postoperative hernias]. Aktualnye voprosy hirurgii Pridnestrovya, Materialy respublikanskoj nauch.-prakt. konf. [Actual issues of surgery of Transnistria, Materials of the Republican scientific and practical. conf.]. Tiraspol.

6. Nudnenko, I. N., Podolinnyj, G. I., & Bernaz, I. L. (2005). Sovershenstvovanie algoritma vybora metoda i materiala pri gryzhesecheniyah [Improving the algorithm for choosing the method and material for herniotomy]. Aktualnye voprosy hirurgii Pridnestrovya [Actual issues of Transnistria surgery], Materialy respubl. nauch.-prakt. konf. Tiraspol.

7. Saenko, V. F., & Belyanskij, L. S. (2003). Aktualnye problemy sovremennoj gerniologii [Actual problems of modern herniology]. Klinichna khirurhiia – Clinical surgery, 11, 3–5.

8. Tarasov, V. V., Sukhodolia, A. I., Hoida, M. S. (2006). Khirurhichne likuvannia pakhvynnykh hryzh za metodom Likhtenshteina [Surgical treatment of inguinal hernias by the method of Liechtenstein]. Standartyzatsiia metodiv likuvannia v plastychnii ta rekonstruktyvnii khirurhii [Standardization of treatment modalities in plastic and reconstructive surgery]: Zbirnyk tez dopovidei II Vseukr. nauk.-prakt. konf. Kyiv.

9. Feleshtynskyi, Ya. P., Shtaier, A. A., & Yosypenko, M. O. (2019). Optymizatsiia transabdominalnoi preperytonyalnoi alospastyky pry retsydyvnykh pakhvynnykh hryzhakh pislia operatsii Likhtenshteina [Optimization of transabdominal preperitoneal alospasty in recurrent inguinal hernia after Liechtenstein surgery]. Khirurhiia Ukrainy – Surgery of Ukraine, 2 (70), 30–33.

10. Yurasov, A. V. (2001). Vybor metoda plastiki posleoperacionnyh ventralnyh gryzh [The choice of the method of plastic surgery of postoperative ventral hernias]. Annaly hirurgii – Annals of Surgery, 6, 65–68.

11. Yanov, V. N., Stavinskij, R. A., Chetverikova, A. V. & Prosyanyj, E. V. (2003). Analiz rezultatov sorokaletnego primeneniya pogruzhnogo autodermalnogo transplantanta v hirurgicheskoj praktike [Analysis of the results of forty years of use of a submersible autodermal transplant in surgical practice]. Klinichna khirurhiia – Clinical surgery, 11, 36.

12. Keith W. Millikan (2003). Incisional hernia repair. Surgery Clin., 83, 1223–1224. DOI: 10.1016/S0039-6109(03)00129-4.
Published
2019-06-27
How to Cite
Khimich, S. D., Zheliba, M. D., Reva, A. I., Funikov, A. V., Prevar, A. P., Formanchuk, A. M., Katelian, O. V., & Rautskis, V. P. (2019). Medical treatment of hernia of abdomen wall with the use of different plastic materials. Reports of Vinnytsia National Medical University, 23(2), 263-266. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2019-23(2)-15