Alloplasty of postoperative ventral hernias in HIV-infected patients
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16194Keywords:
postoperative ventral hernia, HIV infection, allohernioplasty, polyurethane glue, decamethoxine solutionAbstract
The aim of the work: to increase the effectiveness of alloplasty of postoperative ventral hernias in HIV-infected patients.
Materials and Methods. An analysis of the surgical treatment of postoperative ventral hernias (PVH) in 112 HIV-infected patients aged 21 to 55 years (mean patient age – (42.5±1.9) year) was conducted. Depending on the method of PVH alloplasty, patients were divided into two groups. The first group (main group) consisted of 55 (49.1 %) patients in whom alloplasty was performed using an improved method. The essence of the improved method of retromuscular alloplasty was that the fixation of the polypropylene mesh implant to the posterior aponeurotic walls under the rectus muscles was performed with polyurethane glue in combination with the antiseptic decamethoxin. In the second group (comparison), in 57 (50.9 %) patients, alloplasty was performed using the classical method with retromuscular placement of the polypropylene mesh implant and fixation of the mesh with ligatures.
Results. The obtained results of surgical treatment of PVG in HIV-infected patients of the main group confirm higher efficiency compared to the comparison group, due to the use of improved alloplasty by fixing the mesh with polyurethane glue with an antiseptic. The incidence of seroma decreased to 9.1 vs. 28.1%, wound infection – to 7.1 vs. 29.8 %, chronic postoperative pain – to 5.4 vs. 15.8 %, absence of ligature fistulas – 0 vs. 10.5 %, hernia recurrence – to 3.6 vs. 17.5 %.
Conclusions. Surgical treatment of postoperative ventral hernias in HIV-infected patients using polyurethane glue with decamethoxin for fixation of the mesh implant, compared to traditional mesh fixation with ligature, increases the effectiveness of surgical treatment and significantly reduces the incidence of postoperative complications.
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