Surgical Treatment of Large Incisional Hernias by an Intraperitoneal Dacron Mesh and an Aponeurotic Graft

BACKGROUND: The therapeutic problems of giant incisional hernias of the abdominal wall are difficult to resolve. The technique of repair must make up for the loss of abdominal wall substance and reestablish the interplay of the abdominal musculature. The use of prosthetic materials complies with these two imperatives. The aim of this prospective study was to evaluate the results of surgical treatment of postoperative incisional hernias by intraperitoneal insertion of Dacron (DuPont) mesh and an aponeurotic graft. STUDY DESIGN: We prospectively studied 350 consecutive patients who were operated on for giant postoperative incisional hernia. RESULTS: Postoperative mortality was 0.6%. Seven patients (2%) developed subcutaneous infections that did not affect the prostheses. Another seven patients (2%) developed deep-seated infections that necessitated removal of the mesh in five cases. Eleven patients (3.1%) had recurrence of incisional hernia. CONCLUSIONS: This prospective study shows that the intraperitoneal positioning of Dacron mesh and an aponeurotic graft can efficiently treat giant abdominal wall hernias.