Chapter 53 Open Primary and Mesh Repairs
INTRODUCTION
Incisional hernias complicate approximately 10% of all laparotomies. Repair of an incisional hernia is a challenging case and recurrence rates remain high. The first repair of an incisional hernia has the highest likelihood of success; therefore, considerable attention should be given to the surgical strategies that achieve optimal outcomes.1 The key factor associated with decreased likelihood of recurrence is the use of mesh for the repair.2 Long-term results of a randomized trial comparing suture with mesh repair demonstrated a 62% recurrence for suture repair and 32% for mesh repair.3 For small defects (<10 cm2), the efficacy of mesh was even greater, with a 67% recurrence in the suture arm and 17% in the mesh arm. This highlights the fact that even small hernias should have a mesh repair. However, mesh is associated with a twofold increase in the complication rate, some of which, such as mesh infection and fistula formation, can be devastating.3 Therefore, it is important to understand factors associated with increased risk of mesh complications.
PREOPERATIVE CONSIDERATIONS
OPERATIVE PROCEDURE
Preparation of the Patient
Wound Infection
• Consequence
• Prevention
![](https://freepngimg.com/download/social_media/63059-media-icons-telegram-twitter-blog-computer-social.png)
Stay updated, free articles. Join our Telegram channel
![](https://clinicalpub.com/wp-content/uploads/2023/09/256.png)
Full access? Get Clinical Tree
![](https://videdental.com/wp-content/uploads/2023/09/appstore.png)
![](https://videdental.com/wp-content/uploads/2023/09/google-play.png)
![](https://clinicalpub.com/wp-content/uploads/2023/09/banner1.png)