Pathogenesis of Recurrence in Tension Hernioalloplasty

Abstract

The treatment of 146 patients with postoperative ventral hernias was analysed. After local tissue plasty and prosthetic tension hernioplasty a complete recurrence of the disease most often developed. In the recurrence zone a scar with signs of remodelling in the direction of atrophy with foci of granulation tissue and with phenomena of chronic inflammation developed; after tension prosthetic methods - connective tissue with formation of voids around the synthetic prosthesis, leading to inflammatory reaction around the fibres of the prosthesis. The above-mentioned factors together with the increase of intra-abdominal pressure were the bases for the formation of hernia recurrence. In surgical treatment of postoperative ventral hernias it is recommended to use improved methods of hernioalloplasty - "on lay" without suturing the defect with implantation of the endoprosthesis with U-shaped sutures (at W1-W2) or "on lay+sub lay" with creation of a duplicate prosthesis (at W3-W4), which was performed in 56.9% and 19.8% of patients, respectively.