Management of large and giant postoperative ventral hernias

: The experience of the Department for Plastic Surgery of the A.V. Vishnevsky. Institute of Surgery of RAMS in surgical treatment of 262 patients with postoperative hernias of the anterior abdominal wall has been summarized for the period from 1993 to 1998. 138 patients (test group) had large and giant hernias, 124 (control group)--small and middle-sized postoperative hernias. In large and giant hernias more frequently (46.1%) combined plastic reconstruction of the anterior abdominal wall was used rather than in small and middle-sized hernias (21.5%). In the majority of patients in control group (78.5%) autoplasty of the abdominal wall defect was carried out. In the long term period relapses developed in 9 (7.0%) patients of the test group. In 7 cases the relapse developed after the autoplasty (10.1%), and in 2 cases--after the use of combined method (3.4%). This supports perspectiveness of the method of postoperative hernioplasty by the combined method. Lethality rate after hernioplasty in the test group made up 2.3% (3 patients).