[Surgical repair of large defects in the abdominal wall with biosynthetic prosthesis]

The article discusses the results of surgical management of postoperative and posttraumatic hernias with large defects in the anterior abdominal wall in 66 patients. In 56 (80.2%) patients the defect in the abdominal wall measured more than 400 cm2 (20 cm in diameter). The authors developed a method for closure of the defect with a 2-3-layer biosynthetic prosthesis without reducing the volume of the abdominal cavity. The lower layer of the prosthesis is formed by a biological tissue which is covered in sequence with synthetic prostheses (layers) with an increasing destruction period. The authors claim that the method does not require prolonged preoperative management for the prevention of cardiopulmonary and gastrointestinal complications because it supposes maintenance of the optimal volume of the abdominal cavity. No complications on the part of the respiratory organs and disorders of gastrointestinal activity were encountered in the early postoperative period. Peripheral necrosis of the skin occurred in 7 patients, accumulation of serous fluid was encountered in 4 cases and a ligature fistula in one case. The late-term results were studied in 60 patients in follow-up periods of 12 months to 5 years. Recurrent hernias were not found.