The use of mesh in acute XXXX : frequency and outcome in 99 cases.

@entity1 @entity295 @entity834 @entity2737 @entity281 @entity358 @entity547 @entity1756
BACKGROUND: Incarceration of inguinal, umbilical and cicatricial @entity547 is a frequent problem. However, little is known about the relationship between the use of mesh and outcome after surgery. The goal of this study was to describe the relationship between the use of mesh in @entity547 and the clinical outcome. @entity1 AND METHODS: Correspondence, operation reports and @entity1 files between January 1995 and December 2005 of @entity1 presented at one academic and one teaching hospital in Rotterdam were searched for the following keywords: incarceration, strangulation and @entity547 . The @entity1 characteristics, clinical presentation, pre-operative findings and clinical course were scored and analysed. RESULTS: A total of 203 @entity1 could be identified: 76 inguinal, 52 umbilical, 39 incisional, 14 epigastric, 14 femoral, five trocar and three spigelian @entity547 . In the statistical analysis, epigastric, femoral, trocar and spigelian @entity547 were pooled, due to their small group sizes. One @entity1 was excluded from the analysis because the @entity547 was not corrected during operation. In total, 99 @entity547 were repaired using mesh versus 103 primary suture repairs. Twenty-five wound @entity281 were registered (12.3%). One mesh was removed during a reintervention for @entity834 , although no signs of @entity2737 were present. Nine @entity1 died, none of them due to wound-related problems [one cardiovascular, one @entity1756 , two @entity834 , two @entity295 e causa incognita (e.c.i.), three @entity358 ]. Univariate analysis showed that female @entity1 (P  =  0.007), adipose @entity1 (P  =  0.016), @entity1 with an umbilical @entity547 (P  =  0.01) and @entity1 who underwent a bowel resection (P  =  0.015) had a significantly higher rate of wound @entity281 . The type of repair (e.g. primary suture or mesh), use of antibiotic prophylaxis, gender, ASA class and age showed no significant relation with @entity2737 . After logistic regression analysis, only bowel resection (P  =  0.020) showed a significant relation with @entity2737 . CONCLUSIONS: Wound infection rates are high after the correction of acute @entity547 , but clinical consequences are relatively low. Mesh correction of an acute @entity547 seems to be safe and should be considered in every @entity547 .
