Surgery for incarcerated hernia: short-term outcome with or without mesh

Area of Science:

• General Surgery
• Hernia Repair
• Surgical Complications

Background:

• Incarcerated hernias account for 5-15% of operated hernias.
• Tension-free mesh repair is standard for elective cases due to low recurrence.
• No consensus exists for mesh use in incarcerated hernias, particularly with bowel resection.

Purpose of the Study:

• Report current practices for incarcerated hernia treatment.
• Identify risk factors for postoperative complications.
• Assess mesh safety in potentially contaminated surgical fields.

Main Methods:

• Retrospective study of 166 patients undergoing emergency incarcerated hernia repair.
• Data collected: demographics, surgical details, short-term outcomes.
• Univariate analysis to identify risk factors for complications.

Main Results:

• Inguinal hernias were most common (50.6%). Mesh was used in 38.5% of cases, including 5 with bowel resection.
• Overall morbidity was 32.7%, with surgical site infections (SSI) in 4.8%.
• Bowel resection was a risk factor for overall complications and SSI; bowel incarceration predicted major morbidity.

Conclusions:

• High morbidity persists in incarcerated hernia surgery, linked to comorbidities and presentation.
• Mesh placement is feasible and potentially safe, even with concomitant bowel resection.
• Mesh could be integrated into standard practice for incarcerated hernias.