EXPANDED POLYTETRAFLUOROETHYLENE PATCHES USED IN THE INTRAPERITONEAL OR EXTRAPERITONEAL POSITION FOR REPAIR OF INCISIONAL HERNIAS OF THE ANTEROLATERAL ABDOMINAL-WALL

BACKGROUND: Few large studies of the use of expanded polytetrafluoroet hylene (ePTFE) in incisional hernia repairs have been done. We perform ed such a study of ePTFE patches implanted extraperitoneally or intrap eritoneally. METHODS: The records of all patients in whom an ePTFE pat ch was used to repair an incisional hernia in 1987 to 1994 were review ed retrospectively. RESULTS: An ePTFE patch was implanted in 158 patie nts, extraperitoneally in 98 and intraperitoneally in 60. There were n o perioperative deaths. Serious postoperative complications, including 3 cases of sepsis (intraperitoneally placed patch), occurred in 6 pat ients (4%). With a mean followup of 37 months (range 12 to 90), there were 2 cases of late sepsis (with an extraperitoneal patch) and 6 recu rrences (4 with an intraperitoneal patch). CONCLUSIONS: The ePTFE pros theses used in incisional hernia repair are well tolerated in the intr aperitoneal position. Their effectiveness in the extraperitoneal posit ion may be comparable to that of mesh but with a lower rate of sepsis. (C) 1997 by Excerpta Medica, Inc.