Журнал клинических случаев

Early Postoperative Eventration: Surgical Treatment with Use of Biological Prosthesis

Abstract

Sara Colozzi, Marco Clementi, Giovanni Cianca, Giuseppe De Santis, Federico Sista, Francesco Carlei Mario, Schietroma and Gianfranco Amicucci

Purpose: Eventration is a rare complication after laparotomy and its treatment is actually not standardized. We retrospectively analyzed 12 patients with early postoperative eventration; 8 of 12 were treated with use of biological mesh (non-cross-linked porcine derma). Materials and Methods: We observed, from January 2009 to January 2014, 12 patients with eventration. In 4/12 patients we performed a direct abdominal wall closure and these patients were excluded from the study; remaining 8 patients encountered inclusion criteria and were enrolled on study. Study population was composed by 8 patients (6 male, 2 female). Mean age was 53 years (range 35-70). Direct abdominal wall closure was not performed because of the risk of “abdominal compartment syndrome” (ACS). In six of eight patients early post-operative eventration occurred after urgent surgery Surgical technique: in 4 patients we performed direct wall closure with biological prosthesis (porcine derma) (one-step procedure). In 2 patients wall closure with similar technique was delayed after 9 and 12 days of intra-abdominal VAC (vacuum assisted closure) Therapy (two-step procedure). In 2 cases, because of large skin defect, we applied biological prosthesis and a surface VAC Therapy system on the prosthesis after intra-abdominal VAC Therapy (three-step procedure). Results: We observed immediate complications in four cases (seroma). No patients underwent re-eventration. One year after surgery one patient manifested laparocele. Conclusions: In our opinion, in these cases biological prosthesis can be used as valid device. However, our study is limited by number of patients and other studies are needed to draw definitive conclusions.