Year 2013 Vol. 21 No 1

NEW METHODS

N.V. ALEKSANDRENKOV 1, A.S. MYKHIN 2, V.A. REBCOVSKY 3, .. LEONTEV 3

WOUND CLOSURE METHOD AT SUBAPONEUROTIC PLASTY WITH POLYPROPYLENE MESH OF LARGE POSTOPERATIVE VENTRAL HERNIA

SBME KR Babyninsky central regional hospital1, SBEE HPE Nizhny Novgorod State Medical Academy 2,
MEHC City Clinical Hospital 39, Nizhny Novgorod 3,
The Russian Federation

Objectives. To decrease the number of wound complications after subaponeurotic plasty of large postoperative ventral hernia by means of the designed method of the herniotomy wound closure.
Methods. Patients with postoperative ventral hernia were subdivided into 2 groups. In the control group A (31 patients) the vacuum drainages were left in the wound over the mesh and the skin was sewed with the nodal sutures; the drainages were removed 4-5 days afterwards. In the main group B (52 patients) the separated subcutaneous fat was fixed in several layers by thread to the aponeurosis through the mesh endoprosthesis. The wound was not drained. The skin was sewed with the intracutaneous suture. In both groups ultrasound examination of the wound was performed on the 2-5 and 8-12 day. In care of detection seromas exceeding 1 cm in width the puncture method was used.
Results. According to the ultrasound data, large seromas were revealed in 32,5% patients in the group A on 8-12 day. In group B they were detected in 5,7% operated patients. Their number remained unchanged one month afterwards in both groups despite the puncture method of treatment. Total number of the wound complications in groups A and B made up 41,9% and 17,3%, correspondently. Group A patients stayed in hospital within 10-22 days, 13,543,40 on the average, in group B they were discharged on 8-17 days. The average time of hospitalization was 10,962,01 days.
Conclusions. The wound closure over endoprosthesis at herniotomy according to the designed method 2 time reduces wound complications as well as reducen of patients hospitalization up to 2,5 days on the average. It is associated with the ability of small seromas to self-resolve without any treatment. Absence of the cavity drainage and the intracutaneous suture excludes the wound infection.

Keywords: postoperative ventral hernia, endoprosthesis, wound complications, wound closure method
p. 88 93 of the original issue
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Address for correspondence:
249210, Rossiiskaia Federatsiia, Kaluzhskaia oblast', Babyninskii raion, p. Babynino, ul. Molodezhnaia, d. 11, GBUZ KO TsRB Babyninskogo raiona,
e-mail: aleksandrenkov@mail.ru,
Aleksandrenkov Nikolai Vladimirovich
Information about the authors:
Aleksandrenkov N.V. Head of the surgical service of SBME KR Babyninsky central regional hospital.
Mykhin A.S. MD, professor, head of the chair of surgery FPKV SBEE HPE Nizhny Novgorod State Medical Academy of Ministry of Healthcare of Russia.
Rebcovsky V.A. A senior clinical intern of the surgical department of MEHC City clinical hospital 39, Nizhny Novgorod.
Leontev A.E. PhD, a clinical intern of the surgical department of MEHC City clinical hospital 39, Nizhny Novgorod.
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