POSTOPERATIVE VENTRAL HERNIA. SURGERY AND PREVENTIONOF WOUND COMPLICATIONS. LITERATURE REVIEW

Abstract

Introduction. In today’s Kazakhstani and foreign literature there are lots of works devoted to the study of postoperative
ventral hernia. However, the results of their surgical treatments do not always suit both clinicians and the patients
themselves [5, 9, 47, 53, 55, 74]. The development of infectious wound complications in the postoperative period is one of the reasons for the increase in hospitalization duration, the occurrence of hernia recurrence, and the increase in treatment
costs [34, 76, 78, 79].
Purpose.To review the literature data on the surgical treatment of postoperative ventral hernias and the prevention of
wound complications after hernioplasty.
Search strategy. The analysis of full-text scientific publications in the databases of Google Scholar, E-library.ru,
PubMed, Cyberleninka, as well as the “manual” analysis of literary sources was carried out. The period studied was 47
years, from 1970 to 2017. Epidemiology, pathogenesis, recurrence rate, a variety of surgical treatment methods for
postoperative ventral hernias were studied.
Criteria for inclusion: reports of randomized and cohort studies conducted on large populations, systematic reviews, full
versions of articles. In order to conduct a literary review, literature in Russian and English languages was studied as well.
Criteria for exclusion: articles describing isolated cases, summaries of reports, private messages and newspaper
publications, abstracts, personal messages.
A total of 1435 sources were found, 80 of which were selected for further analysis.
Results. Modern concepts of treating patients with postoperative ventral hernia consist in the use of hernioplasty using
mesh endoprostheses [62, 68]. However, their use is accompanied by high rates of wound complications, which include
seromas, infiltrates, rupture and wrinkling of the endoprosthesis [20]. One of the ways to eliminate the hernia orifice and
prevent wound complications is autodermal plastics [61], the others consider the location of grafts requiring clarification to be
the cause of wound complications after hernioplasty. In addition, it is also important to develop simple, effective ways to
prevent complications of postoperative wounds using physical methods of treatment under ultrasound guidance and
indicators of the dynamics of cytokines in the course of the wound process.
Conclusion. Literary data show the need to find and develop new effective and simple methods in the surgical treatment
and management of postoperative wounds in the hernioplasty of ventral hernias for the prevention of wound complications.