Expanded polytetrafluoroethylene patches used in the intraperitoneal or extraperitoneal position for repair of incisional hernias of the anterolateral abdominal wall

BACKGROUND: Few large studies of the use of expanded polytetrafluoroethylene (ePTFE) in incisional hernia repairs have been done. We performed such a study of ePTFE patches implanted extraperitoneally or intraperitoneally. METHODS: The records of all patients in whom an ePTFE patch was used to repair an incisional hernia in 1987 to 1994 were reviewed retrospectively. RESULTS: An ePTFE patch was implanted in 158 patients, extraperitoneally in 98 and intraperitoneally in 60. There were no perioperative deaths. Serious postoperative complications, including 3 cases of sepsis (intraperitoneally placed patch), occurred in 6 patients (4%). With a mean followup of 37 months (range 12 to 90), there were 2 cases of late sepsis (with an extraperitoneal patch) and 6 recurrences (4 with an intraperitoneal patch). CONCLUSIONS: The ePTFE prostheses used in incisional hernia repair are well tolerated in the intraperitoneal position. Their effectiveness in the extraperitoneal position may be comparable to that of mesh but with a lower rate of sepsis. (C) 1997 by Excerpta Medica, Inc.