Medical and Dental Consultantsí Association of Nigeria
Home - About us - Editorial board - Search - Ahead of print - Current issue - Archives - Submit article - Instructions - Subscribe - Advertise - Contacts - Login 
  Users Online: 1761   Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
 
ORIGINAL ARTICLE
Year : 2010  |  Volume : 13  |  Issue : 2  |  Page : 167-172

Challenges in the repair of large abdominal wall hernias in Nigeria: Review of available options in resource limited environments


Department of Surgery, University of Nigeria Teaching Hospital Enugu, Nigeria

Correspondence Address:
E R Ezeome
Department of Surgery, University of Nigeria Teaching Hospital Enugu
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 20499750

Rights and PermissionsRights and Permissions

Objective: To evaluate the challenges and outcome of management of large abdominal wall hernias in a resource limited environment and highlight the options available to surgeons in similar conditions. Design: A review of prospectively collected data on large abdominal wall hernias managed between 2003 and 2009. Setting: University of Nigeria Teaching Hospital, Enugu, Nigeria and surrounding hospitals Subjects: Patients with hernias more than 4cm in their largest diameter, patients with closely sited multiple hernias or failed previous repairs and in whom the surgeon considers direct repair inappropriate. Outcome measures: Demographics of patients with large hernias, methods of hernia repair, recurrences, early and late complications following the repair. Results: There were 41 patients, comprising 28 females and 13 males with ages 14 - 73 years. Most (53.7%) were incisional hernias. Gynecological surgeries (66.7%) were the most common initiating surgeries. Fifteen of the patients (36.6%) have had failed previous repairs, 41.5% were obese, five patients presented with intestinal obstruction. Thirty nine of the hernias were repaired with prolene mesh, one with composite mesh and one by danning technique. Most of the patients had extra peritoneal mesh placement. Three patients needed ventilator support. After a mean follow up of 18.6 months, there was a single failed repair. Two post op deaths were related to respiratory distress. There were 12 wound infection and 8 superficial wound dehiscence, all of which except one resolved with dressing. One reoperation was done following mesh infection and extrusion. Conclusion: Large abdominal wall hernia repair in resource limited environments present several challenges with wound infection and respiratory distress being the most notable. Surgeons who embark on it in these environments must be prepared to secure the proper tissue replacement materials and have adequate ventilation support.


[PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1360    
    Printed52    
    Emailed0    
    PDF Downloaded259    
    Comments [Add]    

Recommend this journal