Re- appraisal of application of mesh in hernia surgery.

Authors

  • Abrar Hussain Zaidi Fauji Foundation Hospital Rawalpindi.
  • Muhammad Taimur Fauji Foundation Hospital, Rawalpindi.
  • Shazia Naqvi NUMS-Rawalpindi.
  • Samiullah Fauji Foundation Hospital, Rawalpindi.
  • Shanza Faridi Zamzama Hospital Hafizabad.
  • Sundas Ishtiaq Fauji Foundation Hospital, Rawalpindi.

DOI:

https://doi.org/10.29309/TPMJ/2023.30.07.7558

Keywords:

Complications, Component Separation and Slide, Exteriorization, Hernias, Mesh Repair, Surgical Site Infection

Abstract

Objective: Evaluation of mesh associated complications and reviewing its selective application in hernia surgery. Design: Descriptive study. Setting: Department of Surgery, Fauji Foundation Hospital, Rawalpindi. Period: Jan 2019 – June 2022. Material & Methods: Patients having undergone hernia surgery in past with mesh repair at FFH or any other hospital that had developed complications and reported to surgical unit 1 FFH. Patients of hernia surgery without mesh repair were excluded. Results: A total of 50 cases were included in the study. Majority of patients were females 42(84%). Paraumbilical hernia 18(36%), Epigastric hernia 13(26%), Incisional hernia 12(24%) and Inguinal hernia 7(14%) cases were included in study. Chronic discharging sinus 16(32%), Recurrent acute local sepsis 12(24%), Large painful seroma 5(10%), Recurrent hernia 13(26%), Acute fulminant sepsis after primary surgery 2(4%) and intestinal obstruction 2(4%) were the mesh associated complications present in patients. Majority of the patient required hospitalization and delayed removal of mesh [43 cases] (86%]. Early removal of mesh was required in 2(4%) cases. The residual defect after the removal of mesh was managed by Component separation and slide method: Early in 2(4%) cases and delayed in 17(34%), double breasting of facial sheath 10(20%), double breasting of external oblique with exteriorization of cord 6(12%) cases. Wound toilet and symptomatic treatment without removal of mesh was advised in 3(6%) cases. Emergency laparotomy and gut anastomosis was performed in 2(4%) cases. Conclusion: Indiscriminate use of mesh needs to be checked, as a significant number of patients develop mesh related complications.

Author Biographies

Abrar Hussain Zaidi, Fauji Foundation Hospital Rawalpindi.

MBBS, FCPS, Associate Professor Surgery, 

Muhammad Taimur, Fauji Foundation Hospital, Rawalpindi.

MBBS, FCPS, Assistant Professor Surgery, 

Shazia Naqvi, NUMS-Rawalpindi.

MBBS, MPH, Assistant Professor Community Medicine, 

Samiullah, Fauji Foundation Hospital, Rawalpindi.

MBBS, FCPS, Professor Surgery, 

Shanza Faridi, Zamzama Hospital Hafizabad.

MBBS, Medical Officer Surgery, 

Sundas Ishtiaq, Fauji Foundation Hospital, Rawalpindi.

MBBS, FCPS, Registrar Surgery, 

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Published

2023-07-02