SURGICAL TREATMENT OPTIMISATION OF RECURRENT ABDOMINAL WALL HERNIAS ASSOCIATED WITH LIGATURE FISTULA.

OBJECTIVE

The aim: To improve the efficiency of treatment of recurrent abdominal wall hernia associated with ligature fistula.

PATIENTS AND

METHODS

Materials and methods: We analysed the results of treatment of recurrent hernias with ligature fistula in 86 patients. 44 patients of group 1 were treated according to the developed algorithm (fistula and mesh explantation, wound debridement, mesh fixation and wound closure with antiseptic-containing polyurethane composite), 42 patient (group 2) were treated according to the traditional one.

RESULTS

Results

Decreased rate of seroma formation in group 1 if compared to group 2 was observed up to 6,7% against 23,8% (OR=0,23; 95%CI=0,06-0,92; р=0,038). Wound infection occurred in 1 (2,3%) case of group 1 against 7 (16,7%) of group 2 (OR= 0,12; 95% CI =0,01-0,99; р=0,027). 4 (9,5%) patients from group 2 developed recurrent ligature fistula (OR= 0,10; 95%CI= 0,01-1,90). Recurrence of hernia was observed in 1 (2,9%) patient of group 1 against 6 (17,7%) patients of group 2 (OR=0,14; 0,01-1,21; р=0,048).

CONCLUSION

Conclusions

Surgical treatment optimisation of recurrent abdominal wall hernia associated with ligature fistula improved the efficiency of treatment, which was proven by the obtained outcomes and relative risk of complications.