Актуальні проблеми сучасної медицини (Jun 2019)
Aloplasty of oncisional ventral hernias of using nanomodified polypropilene mesh
Abstract
Aloplasty of incisional ventral hernia (IVH), method of placement and fixation nanomodified polypropylene mesh retro muscular, buth this is accompanied by a fairly high freguency of postoperative complications from the postoperative wound. In our view, the use of a nanomodified polypropylene mesh modified by carbon nanotubes and an antiseptic of polyhexamethlene guanidme chloride in combination with the method of placement and fixation retro muscular the results of operative treatment of IVH. Aim – to improve the results of operative treatment of incisional ventral hernias in combination with the method of placement and fixation retro muscular nanomodified polypropylene mesh. Materials and methods. The analysis of operative treatment of 148 patients with IVH of has been performed. Depending on the type of mesh used during surgical treatment, patients were divided into 2 groups. In 74 (50%) of Group I patients, method of placement and fixation nanomodified polypropylene mesh retro muscular. In the 2nd group, 74 (50%) patients method of placement and fixation retro muscular of a classic polypropylene mesh. Results and discussion. Statistically significant results were obtained in patients of Group I compared to Group II: seroma was in 24 (32.4±1.2%) in Group II compared to 5 (6.8±0.5%) in Group I (p0.05). Chronic pain in the abdominal wall in 6 – 8 months after surgery was observed in 5 (7.7±0.6)% patients in group II and in 1 (1.5±0.2%) group I (p>0.05), recurrences of hernia were found in 6 (9.2±0.6%) patients of group II, in group I – in 1 (1.5±0.2)% (p<0.05). Conclusion. Operative treatment of IVH method of placement and fixation nanomodified polypropylene mesh retro muscular is more effective compared with the use of the classical polypropylene mesh, namely, reducing the freguency of seroma from 32.4±1.2% in the II group of patients to 6.8±0.5% in group I, respectively, suppurations of postoperative wounds – from 9.5±0.5% to 1.4±0.2%, inflammatory infiltrates – from 12.2±0.6% to 1.4±0.2%, ligaturial fistulas of the anterior abdominal wall – from 7.7±0.5% to 0%, meshoma – from 4.6±0.3% to 0%, chronic postoperative pain – from 7.7±0.6% to 1.5±0.2%, recurrence of hernia–from 9.2±0.6% to 1.5±0.2%.
