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[Monster hernia programme in Hernia Centre Liberec].

J Škach, R Harcubová, V Petráková

    Rozhledy V Chirurgii : Mesicnik Ceskoslovenske Chirurgicke Spolecnosti
    |June 24, 2016
    PubMed
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    This study highlights a specialized Czech program for giant complex ventral hernias, demonstrating advanced reconstruction techniques and comprehensive care. The program addresses significant patient handicaps, aiming to improve outcomes for challenging "monster hernias".

    Area of Science:

    • Herniology
    • Abdominal Wall Reconstruction
    • Surgical Intensive Care

    Background:

    • A unique program in the Czech Republic concentrates patients with giant complex ventral hernias (monster hernias) in a high-volume center since 2012.
    • This approach utilizes advanced perioperative intensive care for complex cases.

    Purpose of the Study:

    • To present the single-center experience in managing giant complex ventral hernias.
    • To detail the essential components and techniques required for successful treatment.

    Main Methods:

    • Operated on 36 patients with giant complex hernias (defect >15 cm, loss of domain >=20%) between 2012-2015.
    • Employed advanced abdominal wall reconstruction techniques including component separation (open and endoscopic), bariatric procedures, and abdominoplasty.

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  • Utilized preoperative planning (CT volumetry) and postoperative care, including negative pressure wound therapy (NPWT) for infected prostheses.

    • Main Results:

    • Negative pressure wound therapy (NPWT) successfully saved 100% of infected prostheses from explantation, including cases with MRSA and ESBL.
    • The study emphasizes the importance of tailoring, preconditioning, and comprehensive postoperative care alongside surgical reconstruction.

    Conclusions:

    • The management of monster hernias is a complex, costly, and time-consuming endeavor.
    • This program is designed for patients with significant health, social, and functional handicaps, addressing the risks of severe health problems and high recurrence rates.