PREVENTIVE SURGICAL MASH AUGMENTATION IN MIDDLE LAPAROTOMY

Aim of this study is to improve the results of treatment of patients undergoing surgical treatment through median laparotomic access by reducing the number of incisional hernias. Materials and methods. During 2016-2018, we operated on 20 patients at high risk of postoperative herniation. All participants of the study signed a voluntary informed consent or refusal to participate in the study. In the main group (10 people) preventive endoprosthesis was applied in the initial closure of laparotomy wound. In the control group (10 people) suturing of postoperative wound was carried out layer by layer by separate nodal sutures or continuous suture on aponeurosis by frequent stitches. The patients ' condition was traced from 3 months to one year. The quality of life was assessed at the same time by means of a survey using the mos SF-36 questionnaire. The statistical comparison of groups was carried out by calculating student's t-test. The data were accepted as reliable at p<0.05. Results in the main group for the monitored period of postoperative hernia formation were not observed. In the control group hernias were formed in 60% of the group. In the main group, the indicators of quality of life on scales were significantly higher than in the comparison group. This is due to the lack of herniation in the study period in patients of the main group. 3 months after preventive endoprosthesis, the parameters of physical functioning did not exceed those of the laparotomy wound, which were similar after routine closure. General indicators of health (GH), vitality (VT) and self-assessed mental health (MH) in patients after a preventive replacement after 6 and 12 months exceeded those in the comparison group. We paid attention to quite high rates of social activity scales of patients of the main group. Conclusions. Preventive endoprosthesis is the method of choice for the closure of laparotomy wounds at high risk of postoperative hernia formation. The technique can significantly reduce the frequency of formation of incision hernias after median laparotomy.