Repairs to Prevent Repeat Hernias

Abdominal hernias fixed with stitches and surgical mesh resulted in fewer reoccurrences of the disorder

(RxWiki News) A concern with abdominal hernias is that they will happen again after they’re fixed. Stitching them together is the traditional method of repair, but that technique alone may not always yield a repair that lasts.

A hernia occurs when an organ in the abdominal cavity, usually the intestines, push through a weak spot in the abdominal wall and into another area of the body. Most hernias do not cause symptoms, but some can be uncomfortable. They can be dangerous, because there is a risk of the intestine losing it's blood supply. 

A new study showed that correcting abdominal hernias with surgical mesh held together with several rows of stitches lowered the number of repeat hernias. However, the procedure might raise other health risks.

"Ask your doctor about hernia repair options."

Mylan Nguyen, MS, of the University of Texas Health Science Center at Houston, was the lead author of this study.

Nguyen and team examined nine clinical trials and observational studies, conducted between 1980 and 2012 and comparing hernia surgeries using rows of stitches (sutures) only to those using the stitches and mesh.

Of the surgeries these researchers reviewed, 637 used mesh and stitches and 1,145 used stitches only. The surgery patients were between 19 and 45 years old.

These researchers concluded that 17 of the 637 patients (2.7 percent) whose surgery involved mesh and stitches had further hernias later on. Among the group undergoing surgical repair using stitches alone, 94 patients (8.2 percent) had repeat hernias.

Despite the lower rate of repeat hernias among the mesh-and-stitches group, the researchers wrote that these patients were at higher risk for getting an infection after surgery or fluid build-up around the repaired hernia.

Based on results from six of the nine studies, these researchers found that fluid build-up occurred in 32 patients (7.7 percent) who received stitches and mesh and 21 (3.8 percent) of those who received stitches only. This research team also found that 31 patients (7.3 percent) receiving mesh and stitches developed infections, while post-surgical infections occurred in 43 patients (6.6 percent) who received stitches alone.

The researchers concluded that the use of surgical mesh with suturing for abdominal hernia repair reduces recurrence rates in comparison with suturing alone, but it increases the risks of seroma formation and infections.

Other studies of the two techniques are needed if their findings are to be fully confirmed, Nguyen and team wrote.

The study was published online February 19 in JAMA.

Study authors did not list any funders of this study.

One of its seven researchers disclosed receiving grants from biotech firms that, among other products, sell human body tissue grafts and blood cell preservatives.

Review Date: 
February 19, 2014