Choice of treatment method for postoperative ventral hernias

Introduction. Eliminating large postoperative hernias is a difficult task, and in patients with obesity, diabetes, and smoking, the risk of postoperative complications increases many times. Study objective. To evaluate the results of treatment of postoperative ventral hernias in overweight patients by using a differentiated approach to the choice of hernioplasty method. Materials and methods. The results of surgical treatment of 135 patients with postoperative ventral hernias in two medical institutions were studied. The first group (68 patients) underwent surgery using an endoprosthetic mesh, the second group (67 patients) underwent an autodermal transplant prepared in oxygenated preparations. Results. Multifactorial logistic regression analysis revealed no significant differences in the incidence of adverse events between the groups (OR = 0,834, 95 % CI [0,456–1,592], p = 0,687). However, there was a significant decrease in the incidence of seromas (7,35 % vs. 1,49 %, p = 0.004). Moreover, skin autotransplantation was associated with a decrease in the incidence of seroma (OR = 0,296, 95 % CI [0,097–0,931], p = 0,042). Conclusion. Hernioplasty using deepithelized autoderm prepared preimplantatively in oxygenated preparations is suitable for the treatment of postoperative ventral hernias in obese patients (BMI ≥ 25 kg/m2), diabetes mellitus, as well as in patients at high risk.