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Treatment of permagna incisional hernia with skin necrosis and abscess: case report

M Assenza1, C Reali1, G Marenga1

  • 1Emergency Department, Division of Emergency Surgery and Trauma. Policlinico Umberto I. 'Sapienza University, Rome, Italy.

La Clinica Terapeutica
|April 29, 2014
PubMed

Insights

Complex ventral incisional hernias are rarely treated. This case highlights successful emergency management of a complex incisional hernia with skin necrosis and bowel perforation using biological mesh and VAC system.

Area of Science:

  • Abdominal Surgery
  • Gastroenterology
  • Surgical Innovation

Background:

  • Ventral incisional hernia rates are declining with new surgical techniques.
  • Complex incisional hernias are less frequently encountered and treated.
  • Emergency management of complex hernias remains challenging.

Observation:

  • A case of a large incisional hernia (permagna) with severe complications including skin necrosis, subcutaneous abscess, and bowel perforation.
  • The patient required prolonged hospitalization due to the severity of the condition.

Findings:

  • Successful emergency surgical management involved hernia reduction, bowel resection, and abdominal wall reconstruction.
  • A biological mesh was utilized for abdominal wall reconstruction.
  • Negative pressure wound therapy (VAC System) was employed post-operatively.

Implications:

  • While no gold standard exists, this multi-modal approach demonstrated positive outcomes.
  • The described procedure resulted in no recurrences, infections, or other post-operative complications in this patient.
  • This case provides a valuable reference for managing complex incisional hernias in emergency settings.

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