Expanded polytetrafluoroethylene patch in hernia repair: a review of clinical experience

The use of an implantable prosthetic material is often needed to repair inguinal and incisional hernias, especially when the local tissue is of poor quality or there is a large defect that would cause excessive tension if closed without patching with prosthetic material. An expanded polytetrafluoroethylene (ePTFE) patch was used in 37 patients between May 1986 and May 1990 to repair 25 direct inguinal and 12 incisional hernias. There was one recurrence in the group of patients with incisional hernia but none in those with a direct inguinal hernia. The recurrence was due to poor collagen ingrowth into the patch and subsequent herniation between two sutures. There were no complications due to infection, adhesions, erosion or fistulization. On the basis of this clinical experience, the authors conclude that the ePTFE patch is almost an ideal abdominal wall substitute, but that because of poor anchorage with tissue reaction alone, the success of the repair depends on the technique of suture placement.