[Principles of surgical treatment of postoperative ventral hernia]

The article deals with the results of surgical treatment of postoperative ventral hernias in 398 patients who underwent operation in 1982-1990; 68.5% of patients had large and giant hernias. In 198 patients (48.4%) the hernias were recurrent. One to 9 concomitant diseases were encountered in 88% of cases, which complicated the course of the postoperative period significantly. Reconstructive operations with the use of auto-allo-xenografts and netted synthetic materials were undertaken when the defect measured 15-20 cm in diameter, as well as in cases of multiple, though lesser in diameter, defects in patients with diseases of the cardiovascular system and lungs in the stage of sub- and decompensation, in hernias of long duration, in large irreducible hernias, and in patients over 60 years of age. A combination of grafts with netted synthetic materials was used when a defect measuring 21 cm or more in diameter was encountered together with the above situations. The late-term results were followed-up in periods of 12 months to 8 years. In 254 cases (69%) auto-allo-xenografts and synthetic materials and, in difficult situations, their combinations were used, with good results in 96% of patients. After plastics in 254 patients with the use of additional materials 2 recurrences (0.7%) were revealed; 3 recurrences (2.6%) were encountered among 113 cases in which the defect was closed with local tissues by means of sutures.