Application of an original fibrin coating in prosthetic hernioplasty in patients with postoperative ventral hernias

Background. The number of patients with large postoperative ventral hernias does not tend to decrease. Recurrent hernias after prosthetic hernioplasty occur in 5–25 %. In 1–10 % of patients, the implant becomes infected with the formation of fistulas.

The aim. To develop and apply an original fibrin coating of the implant to accelerate the processes of fibrosis and fixation of the implant in the tissues in large postoperative ventral hernias.

Material and methods. Experimental studies were carried out on laboratory animals and bench experiments aimed at developing a fibrin composite for coating mesh implants. Examined and operated on using the technology described by V.I. Belokonev. Eighty patients with large postoperative ventral hernias. Among them there were 37 (46.3 %) men and 43 (53.7 %) women. The patients were examined using standard laboratory and instrumental studies.

All patients were divided into 2 groups, comparable by gender, age and size of the hernia defect. Group 1 included patients who underwent only V.I. surgery. Belokoneva. The second group was represented by 30 (37.5 %) patients, where after hernia repair and repair of the aponeurosis defect, a fibrin composite was applied to the mesh implant.

Results. The formation of fibrous tissue and the absence of a pronounced inflammatory reaction in the area of application of the fibrin composite within the abdominal wall were detected. In a clinical study, it was found that in group 1 without implant coverage, infiltrates in the area of the postoperative suture occurred in 5 patients (6.3 %). Small fluid accumulations in 3 (3.8 %) patients.

Conclusion. After using fibrin coating to treat implants, the number of fluid accumulations and infiltrates was lower compared to the main group. No relapses were found in the long-term period up to 1 year.

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