Evaluation of the Use of Low-Density Composite Prosthetic Material Mesh in Treating Large Abdominal Wall Incisional Hernias: A Prospective Clinical Study

Objective: To evaluate the use of low-density composite prosthetic material “ProceedTM mesh” in management of large abdominal wall incisional hernias in adults with an intra-peritoneum onlay method in terms of hernia recurrence. Methods: The study included 22 adult patients suffering from large abdominal incisional hernia with abdominal defect ^!10cm who were admitted to General Surgery Department, Alexandria Main University Hospital (June 2009-December 2011). All patients were operated by intra-peritoneum onlay method using ProceedTM mesh and followed-up for one year. Recurrence was the primary endpoint of the study. Secondary endpoints included seromaformation and superficial wound infection as early postoperative complications, deep surgical site infection, adhesive intestinal obstruction and chronic pain as late postoperative complications. Results: Recurrence occurred in two patients (9.1%). Univariate analysis revealed that size of the defect and surgical site infection are significant risk factors for recurrence. Seroma occurred in 6 patients (27.3%). Superficial wound infection occurred in two patients (9.1%). Two patients (9.1%) had deep surgical site infection that was controlled conservatively, but resulted in recurrence in both patients. Reoperation for recurrence was performed in one of them and no dense adhesions were found between the mesh and underlying viscera. Chronic postoperative pain showed significant improvement with time at 3, 6 and 12 months. None of the cases had adhesive intestinal obstruction. Conclusions: After one year follow-up, proceedTM mesh seems a good choice to be used in open intra-peritoneum repair technique for a large abdominal wall defect. It seems to be effective and safe as its use was not associated with major complications.