The article presents the results of surgical treatment of 103 patients with incisional hernias of median localization. The patients were divided into three clinical groups depending upon the method of surgical treatment. The first main group consisted of 42 patients who underwent retromuscular hernioplasty with synthetic prosthesis with tapered end. The other two groups were the patients of the comparison group. The second group consisted of 19 patients in whom traditional methods of retromuscular herniaplasty were used and the third group - 42 patients in whom the traditional technique of Onlay technique was used. In all patients, a material identical in chemical structure, polypropylene, was used as prosthetic implants. When performing prosthetic hernioplasty, optimal results were obtained in the first two groups of patients with a retromuscular position of synthetic implants. This variant of prosthetic hernioplasty gave lesser relapses, promotes the best anatomical and functional restoration of the anterior abdominal wall. At the same time, the use of the developed methods for cutting out and fixing synthetic implants in patients with incisional ventral hernias reliably (p <0.05) reduces serous exudation by an average of 2.53 days (from 5.88±0.13 to 3.35± 0.07), and the duration of inpatient treatment is 5.78 days less (from 18.12±1.28 to 12.34±0.92) than in the comparison group. The improvement in clinical results is due to two main reasons. Firstly, cutting out tapered synthetic implants according to the proposed technique allows using synthetic implants of a smaller area for hernia surgery, while obtaining a full restoration of the anterior abdominal wall. Secondly, the proposed method for fixing synthetic implants makes it possible to “close” the hernial defect evenly from all sides. This explains the absence of relapses in this clinical group, which contributes to an increase in the efficiency of surgical interventions in patients with incisional ventral hernias of median localization.
incisional ventral hernia, synthetic implants, allohernioplasty
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