Introduction: Prosthetic repair for abdominal wall hernia currently represents the gold standard. However, it is still difficult to identify the correct indication for prosthetic implant in borderline cases. The authors propose evaluating whether a prosthetic implant is absolutely contraindicated in potentially infected operating fields through the review of literature and personal experience. Materials and methods: The authors performed ten prosthetic hernia repairs in potentially contaminated areas, with a preliminary preparation of the retromuscular-preperitoneal space hosting the prosthesis implant, and subsequent performance of the major operation. Results: There were neither major nor minor complications with a 21-month follow-up (mean period). Discussion: It is certain that both in noncomplicated inguinal hernia and in abdominal wall hernia repairs, the use of antibiotics can significantly reduce the number of infections. It is very important to underline that the success of the described procedure can be guaranteed only by an accurate preparation of the preperitoneal space: perfect haemostasis, temporary closure of the space with the insertion of iodine gauzes and suturing the edges, local antibiotic treatment, washing of the cavity, and accurate drainage. Conclusions: Prosthetic repair is the gold standard for inguinal, incisional, and all abdominal wall hernias and should be used, with the method described, even in potentially contaminated areas. The use of prosthesis has to be avoided in clearly infected cases.

Prosthetic repair, intestinal resection, and potentially contaminated areas : safe and feasible ? / G. Campanelli, F.M. Nicolosi, D. Pettinari, E. Contessini Avesani. - In: HERNIA. - ISSN 1265-4906. - 8:3(2004 Aug), pp. 190-192. [10.1007/s10029-004-0242-5]

Prosthetic repair, intestinal resection, and potentially contaminated areas : safe and feasible ?

G. Campanelli
Primo
;
F.M. Nicolosi
Secondo
;
D. Pettinari
Penultimo
;
E. Contessini Avesani
Ultimo
2004

Abstract

Introduction: Prosthetic repair for abdominal wall hernia currently represents the gold standard. However, it is still difficult to identify the correct indication for prosthetic implant in borderline cases. The authors propose evaluating whether a prosthetic implant is absolutely contraindicated in potentially infected operating fields through the review of literature and personal experience. Materials and methods: The authors performed ten prosthetic hernia repairs in potentially contaminated areas, with a preliminary preparation of the retromuscular-preperitoneal space hosting the prosthesis implant, and subsequent performance of the major operation. Results: There were neither major nor minor complications with a 21-month follow-up (mean period). Discussion: It is certain that both in noncomplicated inguinal hernia and in abdominal wall hernia repairs, the use of antibiotics can significantly reduce the number of infections. It is very important to underline that the success of the described procedure can be guaranteed only by an accurate preparation of the preperitoneal space: perfect haemostasis, temporary closure of the space with the insertion of iodine gauzes and suturing the edges, local antibiotic treatment, washing of the cavity, and accurate drainage. Conclusions: Prosthetic repair is the gold standard for inguinal, incisional, and all abdominal wall hernias and should be used, with the method described, even in potentially contaminated areas. The use of prosthesis has to be avoided in clearly infected cases.
Contaminated fields; Correct implantation; Intestinal resection; Mesh; Prosthetic repair
Settore MED/18 - Chirurgia Generale
ago-2004
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/47958
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