Frequency of Post Operative Complications of Mesh Repair in Patients with Paraumbilical Hernia
DOI:
https://doi.org/10.70749/ijbr.v3i7.2862Keywords:
Paraumbilical hernia, Mesh repair, Postoperative complications, Wound infection, SeromaAbstract
Background: Paraumbilical hernia is a common ventral abdominal wall defect frequently managed by mesh repair to reduce recurrence rates. Despite its advantages, mesh implantation may predispose patients to early postoperative complications. This study aimed to determine the frequency of postoperative complications following mesh repair in patients with paraumbilical hernia. Methods: This is a cross-sectional descriptive study, which was carried out at the Department of Surgery, Lady Reading Hospital, Peshawar, between 2 December 2024 and 2 May 2025. One hundred and twenty patient’s anesthetics for elective open mesh repair were included in the study population based on non-probability sequential sampling between 18 and 65 years. Patients that were incarcerated or had their hernias strangled and those that were undergoing active infection were locked out. In all cases, polypropylene mesh was positioned in the sublay position. The 15 days evaluation period included the postoperative complications such as wound infection, seroma, and hematoma. The data were examined with SPSS version 21, and there was the stratification in order to detect relations to demographic and clinical variables. Results: The average age was 41.8 +11.6 years and 56.7% of the patients were females. The general incidence of postoperative complications was 17.5 percent. The most frequent complication was wound infection (8.3%), then seroma (5.8%) and hematoma (3.3%). Diabetes mellitus (p = 0.03) and smoking status (p = 0.04) had significant associations with complications whereas age, gender, BMI, and hypertension did not have significant association with complications. Conclusion: Mesh repair of paraumbilical hernia showed a satisfactory initial morbidity. Surgical outcomes can be further enhanced by optimization of modifiable risk factors like diabetes and smoking.
Downloads
References
1. Surek A, Gemici E, Ferahman S, Karli M, Bozkurt MA, Dural AC, Donmez T, Karabulut M, Alis H. Emergency surgery of the abdominal wall hernias: risk factors that increase morbidity and mortality—a single-center experience. Hernia. 2021 Jun;25(3):679-88.
https://doi.org/10.1007/s10029-020-02293-5
2. Köckerling F, Sheen AJ, Berrevoet F, Campanelli G, Cuccurullo D, Fortelny R, Friis-Andersen H, Gillion JF, Gorjanc J, Kopelman D, Lopez-Cano M. The reality of general surgery training and increased complexity of abdominal wall hernia surgery. Hernia. 2019 Dec;23(6):1081-91.
https://doi.org/10.1007/s10029-019-02062-z
3. Pandya, B., Huda, T., Gupta, D., Mehra, B., & Narang, R. (2021). Abdominal wall hernias: An epidemiological profile and surgical experience from a rural medical college in central India. The Surgery Journal, 7(01), e41-e46.
https://doi.org/10.1055/s-0040-1722744
4. See CW, Kim T, Zhu D. Hernia mesh and hernia repair: a review. Engineered Regeneration. 2020 Jan 1;1:19-33.
https://doi.org/10.1016/j.engreg.2020.05.002
5. Henriksen NA, Montgomery A, Kaufmann R, Berrevoet F, East B, Fischer J, Hope W, Klassen D, Lorenz R, Renard Y, Garcia Urena MA. Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society. Journal of British Surgery. 2020 Feb;107(3):171-90.
https://doi.org/10.1002/bjs.11489
6. Aluja-Jaramillo F, Cifuentes-Sandoval S, Gutiérrez FR, Bhalla S, Menias CO. Pre-and postsurgical imaging findings of abdominal wall hernias based on the European Hernia Society (EHS) classification. Abdominal Radiology. 2021 Nov;46(11):5055-71.
https://doi.org/10.1007/s00261-021-03211-8
7. Chowbey P, Wadhawan R, Subramanian D, Bhandarkar D, Gandhi J, Kumari KL, Baijal M, Khetan M, Kathalagiri MS, Khandelwal P, Lal P. Ventral hernia repair in India: a Delphi consensus. Hernia. 2024 Oct;28(5):1511-23.
https://doi.org/10.1007/s10029-024-03062-4
8. Ezeme C, Mackenzie P, Newton RC. Ventral hernias: understanding the pathogenesis, prevention and repair. Surgery (Oxford). 2024 Jan 1;42(1):22-32.
https://doi.org/10.1016/j.mpsur.2023.11.007
9. Porrello G, Vernuccio F, Alvarez-Hornia Pérez E, Brancatelli G, Cannella R. The benign side of the abdominal wall: a pictorial review of non-neoplastic diseases. Diagnostics. 2022 Dec 17;12(12):3211.
https://doi.org/10.3390/diagnostics12123211
10. Mughal M, Ross D. Management of the post-pregnancy abdomen: the plastic surgical perspective. Hernia. 2021 Aug;25(4):929-38.
https://doi.org/10.1007/s10029-021-02478-6
11. Corduas F, Lamprou DA, Mancuso E. Next-generation surgical meshes for drug delivery and tissue engineering applications: materials, design and emerging manufacturing technologies. Bio-Design and Manufacturing. 2021 Jun;4(2):278-310.
https://doi.org/10.1007/s42242-020-00108-1
12. Najm A, Niculescu AG, Gaspar BS, Grumezescu AM, Beuran M. A review of abdominal meshes for hernia repair—current status and emerging solutions. Materials. 2023 Nov 10;16(22):7124.
https://doi.org/10.3390/ma16227124
13. Pogson-Morowitz K, Porras Fimbres D, Barrow BE, Oleck NC, Patel A. Contemporary abdominal wall reconstruction: Emerging techniques and trends. Journal of clinical medicine. 2024 May 13;13(10):2876.
https://doi.org/10.3390/jcm13102876
14. Shrestha D, Shrestha A, Shrestha B. Open mesh versus suture repair of umbilical hernia: meta-analysis of randomized controlled trials. International Journal of Surgery. 2019 Feb 1;62:62-6.
https://doi.org/10.1016/j.ijsu.2018.12.015
15. Aiolfi A, Cavalli M, Micheletto G, Bruni PG, Lombardo F, Morlacchi A, Bonitta G, Campanelli G, Bona D. Open mesh vs. suture umbilical hernia repair: systematic review and updated trial sequential meta-analysis of randomized controlled trials. Hernia. 2020 Aug;24(4):707-15.
https://doi.org/10.1007/s10029-020-02146-1
16. Zhou H, Shen Y, Zhang Z, Liu X, Zhang J, Chen J. Comparison of outcomes of ventral hernia repair using different meshes: a systematic review and network meta-analysis. Hernia. 2022 Dec;26(6):1561-71.
https://doi.org/10.1007/s10029-022-02652-4
17. Lam K, Smith A, Slater K. Umbilical hernia: could it be the ‘canary in the coal mine’for a more significant abdominal wall problem? ANZ Journal of Surgery. 2022 Oct;92(10):2517-23.
https://doi.org/10.1111/ans.17956
18. Ertekin SC, Ergenc M. Comparing laparoscopic and open umbilical hernia repair: quality of life and outcomes. Current Problems in Surgery. 2024 Aug 1;61(8):101527.
https://doi.org/10.1016/j.cpsurg.2024.101527
19. Wilson RB, Farooque Y. Risks and prevention of surgical site infection after hernia mesh repair and the predictive utility of ACS-NSQIP. Journal of Gastrointestinal Surgery. 2022 Apr 1;26(4):950-64.
https://doi.org/10.1007/s11605-022-05248-6
20. Long DR, Cifu A, Salipante SJ, Sawyer RG, Machutta K, Alverdy JC. Preventing surgical site infections in the era of escalating antibiotic resistance and antibiotic stewardship. JAMA surgery. 2024 Aug 1;159(8):949-56.
https://doi.org/10.1001/jamasurg.2024.0429
21. Dias Rasador AC, da Silveira CA, Lima DL, Nogueira R, Malcher F, Sreeramoju P, Cavazzola LT. Mesh versus suture for elective primary umbilical hernia open repair: a systematic review and meta-analysis. Hernia. 2024 Dec;28(6):2069-78.
https://doi.org/10.1007/s10029-024-03106-9
22. Myers SP, Kulkarni SS, Malik SM, Tevar AD, Neal MD. Hernia management in cirrhosis: risk assessment, operative approach, and perioperative care. journal of surgical research. 2019 Mar 1;235:1-7.
https://doi.org/10.1016/j.jss.2018.09.052
23. Mohamedahmed AY, Zaman S, Ghassemi N, Ghassemi A, Wuheb AA, Abdalla HE, Hajibandeh S, Hajibandeh S. Should routine surgical wound drainage after ventral hernia repair be avoided? A systematic review and meta-analysis. Hernia. 2023 Aug;27(4):781-93.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
