General Surgery
doi: 10.25005/2074-0581-2022-24-4-532-540
SURGICAL WOUND SUPPURATIVE COMPLICATIONS AFTER TENSION-FREE HERNIOPLASTY

M.Kh. Malikov1, F.B. Bokiev2, N.A. Makhmadkulova3, I.T. Khоmidov1, O.M. Khudoydodov1, A.N. Kamolov1

1Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Endoscopic Surgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
3Department of Topographic Anatomy and Operative Surgery named after Professor M.K. Karimov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: Analysis of surgical site suppurative complications after correction of large and giant ventral hernias.

Methods: Various types of hernioplasty were performed on 220 patients with large and giant ventral hernias. Among the total number of patients, tension-free hernioplasty was performed in 123 patients, which accounted for 56% of the total number of patients. Various types of mesh implants were used, as well as different techniques of mesh placement in the area of the hernia ring.

Results: Surgical site suppuration in the postoperative period occurred in 7 patients, which amounted to 5.6%. Partial removal of the mesh polymer implant was carried out only in one case. Timely diagnosis of the complications and adequate sanitation of the surgical site in 6 cases showed a good effect, and the implants did not necessitate removal. In one observation with necrosis of the edges of the wound and suppuration of the surgical site, after partial removal of the implant, a hernia recurrence was noted in the area of the removed mesh. In 6 other cases, there was no recurrence of the pathology during the long-term follow-up.

Conclusion: Surgical site suppurative inflammation in the postoperative period, negatively affecting the outcome of the operation, can contribute to hernia recurrence. Timely diagnosis of complications and adequate sanitation of surgical site in most cases give satisfactory results.

Keywords: Large and giant ventral hernias, hernia recurrence, tension-free hernioplasty, suppurative inflammation.

Download file:

References
  1. Tanaka EY, Yoo JH, Rodrigues AJ, Utiyama EM, Birolini D, Rasslan S. A computerized tomography scans method for calculating the hernia sac and abdominal cavity volume in complex large incisional hernia with loss of domain. Hernia. 2010;14:63-9.
  2. Beck CW, Holzman D, Sharp WK, Nealon HW, Dupont DW, Poulose KB. Comparative effectiveness of hernia vs computed tomography in the diagnosis of incisional hernia. J Am Coll Surg. 2013;216(3):447-53.
  3. Parshikov VV. Vospalitel'nye oslozhneniya proteziruyushchey plastiki bryushnoy stenki: diagnostika, lechenie i profilaktika (obzor) [Inflammatory complications of prosthetic abdominal wall plastic surgery: Diagnosis, treatment and prevention (review)]. SMT.2019;11(3):158-78.
  4. Sukovatykh BS, Valuyskaya NM, Pravednikova NV, Netyaga AA, Kasyanova MA, Zhukovskiy VA. Profilaktika i lechenie posleoperatsionnykh gryzh bokovykh stenok zhivota pri pomoshchi polipropilenovogo endoproteza [Prevention and treatment of postoperative hernias of the lateral walls of the abdomen using a polypropylene endoprosthesis]. Vestnik khirurgii. 2011;170(3):53-7.
  5. Charyshkin AL, Frolov AA. Problemy gernioplastiki u bol’nikh s posleoperatsionnymi i ventral’nymi gryzhami [Problems of hernioplasty in patients with postoperative ventral hernias]. Ul’yanovskiy mediko-biologicheskiy zhurnal. 2015;2:39-46.
  6. Baysiev AKh, Davydenko VV, Lapshin AS, Khairov AM. Sravnitel'nyy analiz techeniya rannego posleoperatsionnogo perioda u patsientov s posleoperatsionnymi ventral'nymi gryzhami posle razlichnykh sposobov nenatyazhnoy gernioplastiki [Comparative analysis of the course of the early postoperative period in patients with postoperative ventral hernias after various methods of non-tensioning hernioplasty]. Vestnik khirurgii. 2014;173(3):24-7.
  7. Vorst AL, Kaoutzanis C, Carbonell AM, Franz MG. Evolution advances in laparascopic ventral and incisional hernia repair. World J Gastrointest Sura. 2015;7(11):293-305.
  8. Mukhtarov ZM, Malkov IS, Alishev OT. Profilaktika ranevykh posleoperatsionnykh oslozhneniy u bol'nykh s posleoperatsionnymi gryzhami [Prevention of wound infectious complicationsin patients with postoperative ventral hernias]. Prakticheskaya meditsina. 2014;5:106-9.
  9. Samartsev VA, Gavrilov VA, Parshakov AA, Kuznetsova MV. Profilaktika ranevykh infektsionnykh oslozhneniy posle gernioplastiki setchatymi protezami: eksperimental'no-klinicheskoe issledovanie [Prevention of wound infectious complications after hernioplasty with mesh prostheses: An experimental clinical study]. Zhurnal imeni akademika Petrovskogo B.V. 2020;8(1):12-21.
  10. Hodgkinson JD, Maeda Y, Leo CA, Warusavitarne J, Vaizey CJ. Complex abdominal wall reconstruction in the setting of active infection and contamination: А systematic review of hernia and fistula recurrence rates. Colorectal Dis. 2017;19(4):319-30.
  11. Polvonov SHK, Rakhmatulloev R, Shamsov NKh, Mirzoyev NM. Otsenka vliyaniya razlichnykh faktorov na razvitie retsidiva u bol'nykh s ventral'nymi gryzhami [Evaluation of different factors on the development of recurrence in patients with ventral hernia]. Zdravookhranenie Tadzhikistana. 2020;3:42-6.
  12. Teshaev OR, Olimkulov YySh. Analiz retsidivov posle alloplastiki posleoperatsionnykh ventral'nykh gryzh [Analysis of recurrences after alloplasty of incisional ventral hernias]. Biologiya i integrativnaya meditsina. 2021;2:77-83.
  13. Nazarov ShK, Ali-Zade SG, Ganiev AE, Anvarov Sh. Funktsional'naya alloplastika retsidivnykh posleoperatsionnykh gryzh peredney bryushnoy stenki [Functional alloplasty of recurrent postoperative hernias of the anterior abdominal wall]. Zdravookhranenie Tadzhikistana. 2022;2:66-73.
  14. Sonis AG, Grachyov BD, Stolyarov EA, Ishutov IV. Profilaktika i lechenie infektsionnykh ranevykh oslozhneniy pri proteziruyushchikh gryzhesecheniyakh [Prevention and treatment of infectious wound complications in prosthetic hernias]. Zhurnal im. prof. Kostyuchyonka B.M. 2014;1(2):16-23.
  15. Bouvier A, Rat P, Fressi-Chbihi F, Bonnetain F, Lacaine F, Mariette C, et al. Abdominal binders after laparotomy: Review of the literature and French survey of policies. Hernia. 2014;18:501-6.
  16. Belokonev VI, Ponomaryova YuV, Pushkin SYu, Melentieva ON, Gulyaev MG. Vozmozhnye prediktory i morfologicheskie aspekty razvitiya seromy posle plastiki gryzhi peredney bryushnoy stenki [Possible predictors and morphological aspects of the development of seroma after hernia repair of the anterior abdominal wall]. Novosti khirurgii. 2014;22(6):665-70.
  17. Malikov MKh, Bokiev FB, Khudoydodov OM, Khomidov IT, Khomidov FM, Makhmadkulova NA. Khirurgicheskaya taktika pri gigantskikh gryzhakh peredney bryushnoy stenki [Surgical treatment strategies for giant abdominal wall hernias]. Vestnik Avitsenny [Avicenna Bulletin]. 2021;23(2):251-61. https://doi. org/10.25005/2074-0581-2021-23-2-251-261
  18. Patti R, Caruso AM, Aiello P, Angelo GL, Buscemi S, Di Vita G. Acute inflammatory response in the subcutaneous versus peri prosthetic space after incisional hernia repair: An original article. BMC Surg. 2014;14:91.
  19. Mikhin IV, Kukhtenko YuV, Panchishkin AS. Bol'shie i gigantskie posleoperatsionnye ventral'nye gryzhi: vozmozhnosti khirurgicheskogo lecheniya (obzor literatury) [Large and giant postoperative ventral hernias: Surgical treatment options (literature review)]. Vestnik VolgGMU. 2014;2:8-16.
  20. Timerbulatov MV, Timerbulatov ShV, Gataulina EZ, Valitova ER. Posleoperatsionnye ventral'nye gryzhi: sovremennoe sostoyanie problemy [Postoperative ventral hernias: The current state of the problem]. Meditsinskiy vestnik Bashkortostana. 2013;8(5):102-7.
  21. Levy S, Moszkowicz D, Poghosyan T, Beauchet A, Chandeze M, Vychnevskaia K, et al. Comparison of complete versus partial mesh removal for the treatment of chronic mesh infection after abdominal wall hernia repair. Hernia. 2018;22(5):773-9.
  22. Chung L, Tse GH, O’Dwyer PJ. Outcome of patients with chronic mesh infection following abdominal wall hernia repair. Hernia. 2014;18(5):701-4.
  23. Ferzoco SJ. A systematic review of outcomes following repair of complex ventral incisional hernias with biologic mesh. Int Surg. 2013;98(4):399-408.

Authors' information:

Malikov Mirzobadal Khalifaevich
Doctor of Medical Sciences, Associate Professor, Head of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: ABG-2983-2021
Scopus ID: 21934165100
ORCID ID: 0000-0002-7816-5521
Author ID: 375497
E-mail: mmirzobadal@mail.ru

Bokiev Fatkhullo Bakhhshuloevich
Candidate of Medical Sciences, Head of the Department of Endoscopic Surgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: ABD-4776-2020
ORCID ID: 0000-0003-2807-2324
SPIN: 5254-1132
E-mail: fathullo-@mail.ru

Makhmadkulova Nigora Akhtamovna
Candidate of Medical Sciences, Assistant of the Department of Topographic Anatomy and Operative Surgery named after Professor M.K. Karimov, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-4269-6611
E-mail: malikovanigora@mail.ru

Khomidov Ilkhomiddin Toirovich
PhD Student, Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
E-mail: Khomidov.1991@list.ru

Khudoydodov Oyatullo Makhmadulloevich
PhD Student, Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
E-mail: doctoroyatullo@mail.ru

Kamolov Amrullo Nazrievich
Candidate of Medical Sciences, Assistant of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Scopus ID: 24329687200
Author ID: 336632
E-mail: amrullokamolov20@gmail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from companies manufacturing medications and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Malikov Mirzobadal Khalifaevich
Doctor of Medical Sciences, Associate Professor, Head of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (907) 305060

E-mail: mmirzobadal@mail.ru

Materials on the topic:
  1. MODERN ASPECTS OF NONPARASITIC LIVER CYSTS
  2. ENDOSCOPIC DIAGNOSTICS AND TREATMENT OF INTRABILIARY RUPTURE OF LIVER HYDATID CYST
  3. THE ROLE OF ENDOTHELIAL DYSFUNCTION IN THE PATHOGENESIS OF LIVER FAILURE IN OBSTRUCTIVE JAUNDICE OF BENIGN ORIGIN
  4. SURGICAL TREATMENT OF INGUINAL HERNIA COMBINED WITH CRYPTORCHIDISM
  5. CLINICAL AND MORPHOLOGICAL EVIDENCE OF THE EFFECTIVENESS OF HYDROGEN PEROXIDE (PERHYDROL) APPLICATION FOR THE RECURRENCE PREVENTION AFTER HYDATID CYSTECTOMY FOR HEPATIC ECHINOCOCCOSIS
  6. CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF PATIENTS WITH UNCOMPLICATED LIVER ECHINOCOCCOSIS
  7. SURGICAL TREATMENT STRATEGIES FOR GIANT ANTERIOR ABDOMINAL WALL HERNIAS
  8. OUR EXPERIENCE OF 4360 LAPAROSCOPIC CHOLECYSTECTOMY FOR CHOLELITHIASIS
  9. RESULTS OF THE USE OF MINIMALLY INVASIVE TECHNOLOGIES IN THE SURGICAL TREATMENT OF HEPATIC ECHINOCOCCOSIS AND ITS COMPLICATIONS
  10. ROLE OF MONOCYTES IN PATHOGENESIS OF GENERALIZED PERITONITIS

◄ Back to the list