Planned ventral hernia with absorbable mesh: a life-saving method in relaparotomy for septic abdomen.

摘要

BACKGROUND: Relaparotomy for abdominal sepsis is occasionally associated with wound edges necrosis and visceral edema prohibiting primary fascial closure. Planned ventral hernia with absorbable mesh is a life-saving method for abdominal wound management in such critically ill surgical patients. OBJECTIVE: Examine results of treatment of patients who underwent relaparotomy for septic abdomen and closure of abdominal wound with absorbable mesh. MATERIAL AND METHOD: A retrospective study of patients who underwent relaparotomy for abdominal sepsis and planned ventral hernia with absorbable mesh between 2004 and 2009 was performed Data analysis included indication for relaparotomy, type of absorbable mesh used, results of treatment, and status of patients during the follow-up period. RESULTS: Twelve patients participated to the present study Polyglycolic acid (Dexon) or polyglactin (Vicryl) mesh were used in six patients each. Final wound coverage was skin grafting in five patients (41.7%), skin flaps in one (8.3%), healing by secondary intention in five (41.7%), and human acellular dermal matrix and skin grafting in one (8.3%). One patient (8.3%) developed enterocutaneous fistula. There was no mortality. The hospital stay ranged from 17 to 201 days (mean 118 days). CONCLUSION: Planned ventral hernia with absorbable mesh is a good alternative in the management of patients who undergo relaparotomy for abdominal sepsis. The procedure is life-saving for these patients.