Page 169 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

reported separately on the outcomes of simple and complex LIH, reported postoperative complications are of all patients with a sublay mesh.
Postoperative mortality following sublay repair was 2.1%. Wound complications were reported in 11%, seroma in 9% and hematoma in 7%. In 91 patients additional dermolipectomy or panniculectomy was performed, without increased complication rates(39, 41). Mesh infection or stulas associated with wound infection developed in 4.7%, requiring removal of the mesh. In most cases of mesh infection, a polyester (PE) prosthesis was used(10). In contrast, mesh infection was observed in only 1 patient (<0.5%) after repair with polypropylene (PP)(40). After sublay repair some studies reported the occurrence of serious complications, such as respiratory failure or pulmonary infection in 4.8% (5/103 patients)(39, 41, 45) and prolonged ileus in 7.7% (5/65)(40) patients. The overall recurrence rate of LIH repair with sublay mesh reinforcement was 3.6% after follow-up from 1-8 years. Recurrence rates between simple and complex LIH did not di er.
Figure 4. Position of meshes in relation to the abdominal wall; onlay (blue dotted line), retromuscular (green dotted line) and preperitoneal (red dotted line) position. In our review ‘sublay position’ consists of meshes in retromuscular or preperitoneal position.
b) Open repair by aponeuroplasty and intraperitoneal mesh (IPOM)
In 2 studies, consisting of 630 patients, additionally to IPOM placement, both anterior rectus sheaths were incised and sutured overlapping together ( gure 3) (49, 50). In all patients a (composite-)PE mesh was implanted. Neither of the articles reported the number of simple and complex LIH in their patient population.
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Review treatment large IH
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