REPAIR OF VENTRAL HERNIAS WITH EXPANDED POLYTETRAFLUOROETHYLENE PATCH

Background Operations for large and recurrent abdominal hernias have a high associated recurrence rate, although it is lower when prosthetic material is used. Expanded polytetrafluoroethylene (ePTFE) seems to b e the best tolerated prosthetic material in surgery. Methods A series of 45 ventral hernias repaired using ePTFE for closure or reinforcemen t of the herniorrhaphy has been evaluated prospectively. Thirty-six we re midline incisional hernias and nine were transverse or pararectal v entral hernias. There were 13 recurrent ventral hernias and three defe cts were operated as an emergency procedure. The patch was sutured to the anterior aponeurosis with a running non-absorbable suture. Some ot her kind of intra-abdominal procedure was undertaken in 12 cases. Resu lts ePTFE was well tolerated. Complications occurred in five patients. Major complications were found in three patients: cutaneous:necrosis requiring a myocutaneous flap; and infection of the prosthesis (primar y, and secondary to enterocutaneous fistula due to diverticulitis, bot h requiring removal of the patch). Mean follow-up was 39 months and he rnia recurrence occurred in only one patient. Conclusion This clinical experience shows that ePTFE is a very reliable prosthetic material fo r the repair of abdominal wall hernias.