PREVENTION OF LOCAL HERNIOPLASTY COMPLICATIONS IN PATIENTS WITH LARGE VENTRAL HERNIAS DUE TO OBESITY

Abstract. Aim. Study of the effectiveness of preventive measures in the development of wound complications of hernioplasty in patients with large ventral hernias who suffer from obesity. Materials and methods. An analysis of the results of treatment of 365 patients with ventral hernias who had obesity of various degrees was carried out. Depending on the condition of the hernia gate, alloplasty was performed in one of three options: «Onlay», «Inlay» or «Sublay» with active drainage. A set of measures to prevent the development of local complications included lowering the body mass index; antibiotic prophylaxis of complications; intraoperative washing of the wound with antiseptic solutions; washing the wound through drainage with solutions of antiseptics; application of an elastic bandage. The results. The use of preventive measures made it possible to reduce the number of complications by 9,3%. The greatest number of complications was observed in patients with III and IV degrees of obesity and in patients who underwent plastic surgery using the «Onlay» method. Conclusions. Obesity is a risk factor for the development of postoperative complications in patients operated on for large ventral hernias. As the method of choice for operative treatment, it is recommended to use the «Sublay» technique. The use of a complex of preventive measures allows to reduce the frequency of local complications and reduce the length of stay of patients in the hospital.