COMPARISON OF THE CLINICAL EFFICACY OF DIFFERENT ABDOMINAL WALL HERNIOPLASTY METHODS USING STANDARD VERSUS NAFION-COATED MESH PROSTHESES

The use of various coatings to increase the biocompatibility of endoprostheses in the repair of postoperative ventral hernias (PVH) is a prominent trend in contemporary herniology. Objective: The study aimed to evaluate the clinical effectiveness of on-lay hernioplasty and anterior component separation using traditional endoprostheses versus Nafion-coated endoprostheses. Methods: A prospective, non-randomized study was conducted on 140 patients divided into two groups. The study group (n=60) underwent repair using a polypropylene endoprosthesis with a Nafion coating. The control group (n=80) received a traditional endoprosthesis. Groups were further divided into subgroups based on the surgical technique: Subgroups 1A (n=25) and 2A (n=35) underwent on-lay repair, while Subgroups 1B (n=40) and 2B (n=40) underwent anterior separation hernioplasty. All patients underwent standard examinations with a 6-month follow-up. The incidence, nature, and timing of suppurative complications, inflammatory infiltrates, and the volume of lymphorrhea were recorded. Statistical analysis was performed using SPSS 17.0 (IBM Corp., Armonk, NY, USA). Results: For hernia defects up to 5 cm, the use of Nafion-coated endoprostheses yielded results identical to traditional meshes, regardless of the repair method. However, for defects between 5 cm and 15 cm, significant differences were noted. The Nafion-coated group showed negative wound cultures for pathogenic microflora. Furthermore, separation repairs using the Nafion-coated mesh resulted in significantly lower rates of purulent complications, infiltrates, and seromas compared to the control group. Conclusion: The use of Nafion-coated polypropylene endoprostheses in various types of anterior abdominal wall repair for PVH patients led to a significant reduction in postoperative lymphorrhea and purulent-inflammatory complications. Keywords: Postoperative ventral hernia, separation hernioplasty, Nafion, wound suppuration, seroma, polypropylene endoprosthesis.