Planned Ventral Hernia with Absorbable Mesh: A Life-Saving Method in Relaparotomy for Septic Abdomen
Suvit Sriussadaporn MD*, Sukanya Sriussadaporn MD*, Rattaplee Pak-art MD*, Krittaya Krittayakirana MD*, Supparerk Prichayuhd MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Background : Relaparotomy for abdominal sepsis is occasionally associated with wound edges necrosis and visceral edema
prohibiting primary fascial closure. Planned ventral hernia with absorbable mesh is a life-saving method for abdominal
wound management in such critically ill surgical patients.
Objective : Examine results of treatment of patients who underwent relaparotomy for septic abdomen and closure of abdominal
wound with absorbable mesh.
Material and Method: A retrospective study of patients who underwent relaparotomy for abdominal sepsis and planned
ventral hernia with absorbable mesh between 2004 and 2009 was performed. Data analysis included indication for relaparotomy,
type of absorbable mesh used, results of treatment, and status of patients during the follow-up period.
Results : Twelve patients participated to the present study. Polyglycolic acid (Dexon) or polyglactin (Vicryl) mesh were used in
six patients each. Final wound coverage was skin grafting in five patients (41.7%), skin flaps in one (8.3%), healing by
secondary intention in five (41.7%), and human acellular dermal matrix and skin grafting in one (8.3%). One patient (8.3%)
developed enterocutaneous fistula. There was no mortality. The hospital stay ranged from 17 to 201 days (mean 118 days).
Conclusion : Planned ventral hernia with absorbable mesh is a good alternative in the management of patients who undergo
relaparotomy for abdominal sepsis. The procedure is life-saving for these patients.
Keywords : Abdominal sepsis, Relaparotomy, Absorbable mesh, Planned ventral hernia
