SURGICAL TREATMENT OPTIMISATION OF RECURRENT ABDOMINAL WALL HERNIAS ASSOCIATED WITH LIGATURE FISTULA

Abstract

The aim: To improve the efficiency of treatment of recurrent abdominal wall hernia associated with ligature fistula. Materials and methods: We analysed the results of treatment of recurrent hernias with ligature fistula in 86 patients. 44 patients of group 1 were treated according to the developed algorithm (fistula and mesh explantation, wound debridement, mesh fixation and wound closure with antiseptic-containing polyurethane composite), 42 patient (group 2) were treated according to the traditional one. Results: Decreased rate of seroma formation in group 1 if compared to group 2 was observed up to 6,7% against 23,8% (OR=0,23; 95%CI=0,06-0,92; р=0,038). Wound infection occurred in 1 (2,3%) case of group 1 against 7 (16,7%) of group 2 (OR= 0,12; 95% CI =0,01-0,99; р=0,027). 4 (9,5%) patients from group 2 developed recurrent ligature fistula (OR= 0,10; 95%CI= 0,01-1,90). Recurrence of hernia was observed in 1 (2,9%) patient of group 1 against 6 (17,7%) patients of group 2 (OR=0,14; 0,01-1,21; р=0,048). Conclusions: Surgical treatment optimisation of recurrent abdominal wall hernia associated with ligature fistula improved the efficiency of treatment, which was proven by the obtained outcomes and relative risk of complications.