The outcome of using a prosthetic mesh in the repair of emergent abdominal midline incisional hernias: a prospective comparative study

Objective The aim of the study is to evaluate the efficiency and safety of mesh repair in emergent complicated midline incisional hernias as well as the impact on the early postoperative (PO) morbidity and mortality to implement the best patient management procedure. Patients and methods The study includes 60 patients with emergent midline incisional hernias. Patients were divided according to the type of closure of hernia defect into two groups, group A (30 patients) was managed with a prosthetic mesh repair and group B (30 patients) was managed by primary suture repair. We used the alternation method as an allocation process. Patients in both groups were monitored during operations and along the PO period. The data collected include the patients' condition at presentation, coexisting disease, operative data and PO complications, length of hospital stay, surgical site infection (SSI) and recurrence rates. Results A total of 60 patients underwent operations for emergent midline incisional hernias with (N=30) and without (N=30) the use of mesh repair. There is no significant difference between mesh and nonmesh groups about the mean operative time (P>0.05). Besides, there was no significant difference between both groups concerning the total hospital stay days. The SSI rate in the mesh repair group was 10%, while it was 6.7% in the primary suture repair group. The SSI rate was high among diabetic patients and those with chronic liver illness. The follow-up period ranged between 25 and 48 months with a significant difference between both groups regarding the recurrence rate (P<0.05). Conclusion Our prospective study offers an evidence that with adequate antiseptic precautions, it is possible and safe to use a nonabsorbable mesh in the repair of emergent abdominal wall midline incisional hernias with a significant decline in the recurrence rate.