Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2014 Vol. 22 No 6

REVIEWS

D.V. NAREZKIN, E.V. SERGEEV

PREVENTIVE METHODS OF PYO-INFLAMMATORY WOUND COMPLICATIONS IN HERNIOTOMY OF STRANGULATED POSTOPERATIVE VENTRAL HERNIAS

SBEE HPE “Smolensk State Medical Academy”,
The Russian Federation

All activities for the prevention of wound complications in the surgical treatment of strangulated postoperative ventral hernias of the anterior abdominal wall can be divided into three types: preoperative, intraoperative and postoperative. Historically the most common preoperative method to prevent wound complications is considered to be antibiotic prophylaxis. Intraoperative methods are the most used however, they are very controversial. At the present stage the mesh implants and suture material with antibacterial properties are actively commonly introduced.
Considerable importance is given to the application of low-temperature plasma or laser, as the methods of intraoperative prevention. Important preventive value within the surgical treatment is considerd to eliminate bacterial load in an infected wound and the drainage. In the postoperative period the majority of preventive measures are focused at reducing, early diagnosis and evacuation of pathological accumulations of fluid in the wound.
Today the methods of ultrasonographic diagnosis or computed tomography are considered to be fast, safe and effective in confirming the presence of pathological fluid.
Despite improved methods of prevention of wound postoperative complications of herniotomy of strangulated postoperative ventral hernias at present there is no clear algorithm of preventive measures application.

Keywords: postoperative ventral hernia, wound complications, hernioplasty
p. 743-749 of the original issue
References
  1. Belokonev VI, Pushkin SIu, Fedorina TA, Nagapetian SV. [Biomechanical concept of the pathogenesis of postoperative ventral hernias]. Vestn Khir Im II Grekova. 2000;(5):23–27.
  2. DiBello JN Jr, Moore JH Jr. Sliding myofascial flap of the rectus abdominus muscles for the closure of recurrent ventral hernias. Plast Reconstr Surg. 1996 Sep;98(3):464–69.
  3. Yahchouchy-Chouillard E, Aura T, Picone O, Etienne JC, Fingerhut A. Incisional hernias. I. Related risk factors. Dig Surg. 2003;20(1):3–9.
  4. Iagudin MK. Prognozirovanie i profilaktika ranevykh oslozhnenii posle plastiki ventral'nykh gryzh [Prediction and prevention of wound complications after plastic ventral hernias]. Khirurgiia. 2003;(11):54–60.
  5. Kostiuchenko AL, Bel'skikh AN, Tulupov AN. Intensivnaia terapiia posleoperatsionnoi ranevoi infektsii i sepsisa [Intensive therapy of postoperative wound infection and sepsis]. Saint-Petersburg, RF: Foliant. 2000. 376 p.
  6. Timoshin AD, Iurasov AV, Shestakov AL. Khirurgicheskoe lechenie pakhovykh i posleoperatsionnykh gryzh briushnoi stenki [Surgical treatment of inguinal hernias and postoperative abdominal wall]. Triada-Kh. 2003. 144 p.
  7. Nosov VG, Usov SA. Profilaktika infektsii v oblasti khirurgicheskogo vmeshatel'stva pri alloplastike pakhovykh i intsizionnykh ventral'nykh gryzh [Prevention of infection in surgery for alloplasty of inguinal and incisional ventral hernias]. Biul VSNTs SO RAMN. 2005;(3):259–60.
  8. Fedorov VD, Pleshkov VG, Strachunskii LS, Bedenkov AV. Perioperatsionnaia antibiotikoprofilaktika v abdominal'noi khirurgii [Perioperative antibiotic prophylaxis in abdominal surgery]. Posobie dlia vrachei. Smolensk. 2004; 17 p.
  9. Baiazitov NR. Effektivnost' alloplastiki pri lechenii gigantskoi posleoperatsionnoi i retsidivnoi gryzhi zhivota [Alloplasty efficiency in the treatment of giant and postoperative recurrent abdominal hernia]. Kl³n³chna Kh³rurg³ia. 2000;(5):19–21.
  10. Baulin NA, Gavrilenko NA, Goriunov NA, Stepkin AV. Profilaktika ranevykh oslozhnenii i retsidivov pri bol'shikh ventral'nykh gryzhakh [Prevention of wound complications and recurrences at large ventral hernias]. Vestn Khirurgii. 1986;(9):46–47.
  11. Abbaszade TN. Profilaktika ranevykh oslozhnenii pri gernioplastike bol'shikh ventral'nykh gryzh s ispol'zovaniem argonoplazmennoi koaguliatsii i drenazhnoi sistemy "Unovac" [Prevention of wound complications in hernia repair of large ventral hernias using argon plasma coagulation and drainage system "Unovac"]. Gerniologiia. 2009;(3):5.
  12. Moshkova TA, Vasil'ev CB, Oleinik VV, Morozov AB. Otsenka raznykh sposobov razmeshcheniia polipropilenovykh setok pri alloplastike ventral'nykh gryzh [Evaluation of different methods of placement of polypropylene mesh in alloplasty ventral hernias]. Vestn Khirurgii im Grekova. 2007;(2):78–81.
  13. Patel KM, Bhanot P, Franklin B, Albino F, Nahabedian MY. Use of intraoperative indocyanin-green angiography to minimize wound healing complications in abdominal wall reconstruction. J Plast Surg Hand Surg. 2013 Dec;47(6):476–80.
  14. Cho J, May A, Ryan H, Tsuda S. Intraoperative use of fluorescent imaging with indocyanine green changes management of abdominal wall flaps during open ventral hernia repair. Surg Endosc. 2014 Oct 8.
  15. Kukosh MV, Gomozov GI, Razumovskii NK. Ushchemlennaia gryzha [Strangulated hernia]. Remedium Privolzh'e. 2008; (6):7–10.
  16. Topcu O, Kurt A, Soylu S, Akgol G, Atabey M, Karakus BC, Aydin C. Polypropylene mesh repair of incarcerated and strangulated hernias: a prospective clinical study. Surg Today. 2013 Oct;43(10):1140–44.
  17. Bessa SS, Abdel-Razek AH. Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated ventral hernias: a seven years study. Hernia. 2013 Feb;17(1):59–65.
  18. Wysocki A, Strzalka M, Budzynski P. Tension-free technique for the repair of strangulated abdominal hernia]. [Article in Polish] Przegl Lek. 2011;68(3):154–56.
  19. Abd Ellatif ME, Negm A, Elmorsy G, Al-Katary M, Yousef Ael-A, Ellaithy R. Feasibility of mesh repair for strangulated abdominal wall hernias. Int J Surg. 2012;10(3):153–56.
  20. Neliubin PS, Galota EA, Timoshin AD. Khirurgicheskoe lechenie bol'nykh s posleoperatsionnymi i retsidivnymi ventral'nymi, gryzhami [Surgical treatment of patients with postoperative and recurrent ventral hernias]. Khirurgiia. 2007;(7):69–74.
  21. Basoglu M, Yildirgan MI, Yilmaz I, Balik A, Celebi F, Atamanalp SS, Polat KY, Oren D. Late complications of incisional hernias following prosthetic mesh repair. Acta Chir Belg. 2004 Aug;104(4):425–28.
  22. Belianskii LC, Todurov IM, Manoilo NV. Osobennosti khirurgicheskogo lecheniia defektov briushnoi stenki u bol'nykh s massivnymi-povrezhdeniiami funktsional'nykh myshechnykh kompleksov [Features of surgical treatment of abdominal wall defects in patients with massive injuries of muscle functional complexes]. Gerniologiia. 2007;(3):29–31.
  23. Podoluzhnyi VI, Karmadonov AV, Perminov AA. Khronicheskie seromy pri nadaponevroticheskom raspolozhenii proteza u bol'nykh s gryzhami zhivota [Chronic seroma with overaponeurotic location of the prosthesis in patients with abdominal hernias]. Moscow, RF: Vestn Gerniologii. 2007(2):25–26.
  24. Fedorov IV, Slavin LE, Kochnev AV. Seroma kak oslozhnenie khirurgii gryzh zhivota [Seroma as a complication of surgery of abdominal hernias]. Vestn Gerniologii. 2006;(2):195–98.
  25. Franneby U, Gunnarsson U, Wollert S, Sandblom G. Discordance between the patient's and surgeon's perception of complications following hernia surgery. Hernia. 2005 May;9(2):145–49.
  26. Heartsill L, Richards ML, Arfai N, Lee A, Bingener-Casey J, Schwesinger WH, Sirinek KR. Open Rives-Stoppa ventral hernia repair made simple and successful but not for everyone. Hernia. 2005 May;9(2):162–66.
  27. Tsverov IA, Bazaev AV. Otsenka osnovnykh sposobov alloplastiki s tsel'iu optimizatsii lecheniia bol'nykh s posleoperatsionnymi ventral'nymi gryzhami [Evaluation of the main ways alloplasty to optimize the treatment of patients with postoperative ventral hernias]. Sovrem Tekhnologii v Meditsine. 2011;(2):73–76.
  28. Tsverov IA, Bazaev AV. Khirurgicheskoe lechenie bol'nykh s ventral'nymi gryzhami: sovremennoe sostoianie voprosa [Surgical treatment of patients with ventral hernias: current state of affairs]. Sovrem Tekhnologii v Meditsine. 2010;(4):122–27.
  29. Vichova B, Oravsky M, Schnorrer M. Scar hernia repairs using a mesh--the sublay technique. [Article in Slovak] Rozhl Chir. 2008 Mar;87(3):138–40.
  30. Conze J, Binnebosel M, Junge K, Schumpelick V. Incisional hernia - how do I do it? Standard surgical approach. [Article in German] Chirurg. 2010 Mar;81(3):192–200.
  31. Cox TC, Pearl JP, Ritter EM. Rives-Stoppa incisional hernia repair combined with laparoscopic separation of abdominal wall components: a novel approach to complex abdominal wall closure. Hernia. 2010 Dec;14(6):561–67.
  32. Kaoutzanis C, Leichtle SW, Mouawad NJ, Welch KB, Lampman RM, Cleary RK Postoperative surgical site infections after ventral/incisional hernia repair: a comparison of open and laparoscopic outcomes. Surg Endosc. 2013 Jun;27(6):2221–30.
  33. Schumpelick V. Klinge U. Intermediate follow-up results of sublay polypropylene repair in primary and recurrent incisional hernias. Verlag Berlin Heidelberg. 1999:313–26.
  34. Khodak VA, Petrov VV, Romanov RV, Parshikov VV. Plastika briushnoi stenki setkoi po besshovnoi tekhnologii [Plastic surgery mesh on seamless technology] [Elektronnyi resurs]. Medsovet info. Rezhim dostupa: http://www.medsovet.info/book/content_1661.
  35. Parshikov VV, Petrov VV, Khodak VA, Samsonov AA, Romanov RV, Gradusov VP, Baburin AB. Sovremennye tekhnologii v khirurgii gryzh perednei briushnoi stenki [Modern technologies in surgery of the anterior abdominal wall hernias]. Sovrem Tekhnologii v Meditsine. 2009;(1):32–38.
  36. Cavallaro A, Lo Menzo E, Di Vita M, Zanghi A, Cavallaro V, Veroux PF, Cappellani A. Use of biological meshes for abdominal wall reconstruction in highly contaminated fields. World J Gastroenterol. 2010 Apr 21;16(15):1928–33.
  37. Desiaterik V², M³khno SP, Shapovaliuk VV, Kotov OV, Aksentºv SO. Diferents³iovanii p³dkh³d do l³kuvannia p³sliaoperats³ino¿ grizh³ r³zno¿ lokal³zats³¿ [The differentiated approach to the treatment of postoperative hernia]. Kl³n³ch Kh³rurg³ia. 2003;(11):16–17.
  38. Voskresenskii PK, Emel'ianov SI, Ionova EA. Nenatiazhnaia gernioplastika [The tension-free hernioplasty]. Medpraktika. 2002. 148 p.
  39. Kubo G, Rose J. [Rectusbanding by polypropylene-mesh--a new method for incisional hernia repair]. [Article in German] Zentralbl Chir. 2002 Jul;127(7):583–88.
  40. Schier F, Danzer E, Bondartschuk M. Incidence of contralateral patent processus vaginalis in children with inguinal hernia. J Pediatr Surg. 2001 Oct;36(10):1561–63.
  41. Maistrenko NA, Bakhtin MIu, Tkachenko AN, Fedorov DIu. Vozmozhnosti prognozirovaniia gnoino-vospalitel'nykh oslozhnenii pri khirurgicheskom lechenii bol'nykh s neretsidivnoi posleoperatsionnoi ventral'noi gryzhei [Potential of prediction of pyo-inflammatory complications in surgical treatment of patients with not recurred post-surgical ventral hernia]. Vest Khirurgii im II Grekova. 2000;159(1):68–72.
  42. Gostishchev VK, Omel'ianovskii VV. Puti i vozmozhnosti profilaktiki infektsionnykh oslozhnenii v khirurgii [Ways and abilities of prevention of complications in surgery]. Khirurgiia. 1997;(8):11–15.
  43. Basin BIa. Sovremennyi gernioprotez s antibakterial'nym i protivovospalitel'nym deistviem: peredovye tekhnologii [Modern hernyoprosthesis with antibacterial action and anti-imflammatory: advanced technology]. Katalog Proizvoditelei i Postavshchikov, RF: 2009:6–7.
  44. Ïîñòðåëîâ ÍÀ, Áàñèí Áß, Ïëàòîíîâ ÑÈ, Áàñèí ÃÅ, Àôèíîãåíîâ ÃÅ, Àôèíîãåíîâà ÀÃ, Êëþåâ ÀÍ. Novyi gernioprotez s antibakterial'nym i protivovospalitel'nym deistviem [New hernioprosthesis with an antibacterial and anti-inflammatory effects] [Elektronnyi resurs]. Available from: http://www.medsovet.info/book/content_1646.
  45. Wiegering A, Sinha B, Spor L, Klinge U, Steger U, Germer CT, Dietz UA. Gentamicin for prevention of intraoperative mesh contamination: demonstration of high bactericide effect (in vitro) and low systemic bioavailability (in vivo). Hernia. 2014 Oct;18(5):691–700.
  46. Mokhov EM, Evtushenko NG, Sergeev AN. Primenenie biologicheski aktivnogo (antimikrobnogo) shovnogo materiala pri khirurgicheskom lechenii gryzh perednei briushnoi stenki [The use of biologically active (antimicrobial) suture in the surgical treatment of abdominal wall hernias]. Vestn Eksperemen i Klin Khirurgii. 2012;5(4):648–54.
  47. Narezkin DV, Pekhov AI, Sergeev EV, Markova IaA. Sposob profilaktiki gnoino-vospalitel'nykh ranevykh oslozhnenii pri alloplastike ushchemlennykh posleoperatsionnykh ventral'nykh gryzh [A method for preventing inflammatory wound complications in alloplasty of strangulated postoperative ventral hernias]: pat. ¹ RU 2449820 Rossiiskoi Federatsii; patentoobladatel': gos. obrazovatel'noe uchrezhdenie vysshego professional'nogo obrazovaniia Smolenskaia gosudarstvennaia meditsinskaia akademiia. Zaiavka: ¹2010146505/14. – 2010. MPK A61N5/00 ¹ RU 2449820. Publikatsiia 10.05.12 // 2012. biul. ¹ 13.
  48. Il'chenko FN. Profilaktika vospalitel'nykh oslozhnenii zazhivleniia rany u bol'nykh s posleoperatsionnoi gryzhei zhivota [Prevention of inflammatory complications of wound healing in patients with postoperative abdominal hernias]. Kl³n³chna Kh³rurg³ia. 2002;(11/12):31-33.
  49. Schumpelick V, Klinge U, Junge K, Stumpf M. Incisional abdominal hernia: the open mesh repair. Langenbecks Arch Surg. 2004;(389):1-5.
  50. Crespi G, Giannetta E, Mariani F, Floris F, Pretolesi F, Marino P. Imaging of early postoperative complications after polypropylene mesh repair of inguinal hernia. Radiol Med. 2004 Jul-Aug;108(1-2):107–15. [Article in English, Italian].
Address for correspondence:
214019, Rossiyskaya Federatsiya,
g. Smolensk, ul. Krupskoy, d. 28,
GBOU VPO «Smolenskaya gosudarstvennaya
meditsinskaya akademiya»,
kafedra gospitalnoy khirurgii,
tel. 7-980-310-10-10,
e-mail: br.rus32@gmail.com,
Sergeev Evgeniy Valerevich
Information about the authors:
Narezkin D.V. MD, professor, Vice-rector for dealing with practical public health and post-educational training, Head of the hospital surgery chair of SBEE HPE “Smolensk State Medical Academy”.
Sergeev E.V. A post-graduate student of the faculty surgery chair of SBEE HPE “Smolensk State Medical Academy”.
Contacts | ©Vitebsk State Medical University, 2007-2023