Strangulated hernias and eventrations: prosthesis versus simple suture repair

Despite the established position of prosthetic repair as the standard for the planned cure of abdominal hernias and eventrations, its application in cases of strangulation remains limited, mainly due to the risk of infection. The primary aim of our study was to compare prosthesis and stent cure for strangulated hernias and eventrations in terms of surgical site infection. The secondary objectives were to compare the two techniques in terms of length of hospital stay, non-specific surgical and medical morbidity, recurrence and death.

We conducted a retrospective comparative study of 194 patients operated on for strangulated hernia or eventration, aged over 18 years and with an ASA score of 1 or 2. Patients who required bowel resection were excluded.

The two populations were comparable in terms of preoperative data (age (P = 0.15), gender (P = 0.07), medical and surgical history (P = 0.3 and 0.55) and ASA score (P = 0.17)) and intraoperative data (type of eventration (P = 0.69), contents of the sac (P = 0.56), vitality of the contents (P = 0.25), intraperitoneal effusion (P = 0.39), intraoperative incident (P = 0.49)). Our study showed that there was no significant difference between the two groups in terms of suppuration of the surgical site (P = 0.26). Furthermore, there was no significant difference in terms of length of hospital stay (P = 0.4), scrotal haematoma for patients operated on for groin hernia (P = 0.68), non-specific surgical complications (P = 0.37) or medical complications (P = 0.26) and death (P = 0.58). Recurrence was less frequent in patients who had had a prosthesis (P = 0.044).

We can confirm that the cure of strangulated hernias and eventrations by prosthesis is safe and effective, and gives similar results to the cure by raphia in terms of suppuration of the surgical site.