Uso de mallas de polipropileno en el reparo de la hernia inguinal con herida sucia o contaminada

Introduction. Hernioplasty with polypropylene mesh is the technique of choice for the repair of inguinal hernias. Currently, there is controversy about this technique in patients with dirty or contaminated wounds; However, evidence in the medical literature has shown that its use may be safe. The authors present their experience with polypropylene meshes in contaminated surgery for closure of inguinal hernias. Method. A retrospective observational study was conducted in which patients over 18 years of age attended between January 2017 and December 2018 for presenting inguinal hernias, requiring emergency surgical treatment, and presenting dirty or contaminated wounds were included. The criteria evaluated were: surgical wound infection, morbidity and mortality, need for mesh removal and hernia recurrence. Results. Ten patients underwent emergency surgery, requiring bowel resection for necrosis: nine of them for strangulated hernias and one for perforated appendicitis. In one of the ten patients, the wound was considered dirty due to intestinal necrosis and perforation. The remaining nine had intestinal necrosis without perforation, which was considered contaminated wounds. Wound infection occurred in 1/10 patients with superficial operative site infection; Mesh removal was not necessary in any patient during the entire study period. No recurrences were observed and there was no mortality. Conclusion. The use of polypropylene mesh for the correction of inguinal hernias, in patients with dirty or contaminated wounds, is effective and safe, with acceptable morbidity and good short-term results.