Vol. 5, Issue 1, Part G (2021)

Introduction and Background: Mesh repair has replaced other methods as the gold standard for reducing the risk of recurrence after surgery for ventral hernias. Wound infections, delayed healing, and recurrence are risk factors for surgical complications in patients with diabetes mellitus and obesity. The results of mesh repair in high-risk populations like these must be studied because these co-morbidities are becoming increasingly common, particularly in developing nations. Patients with a ventral hernia and co-occurring diabetes and/or obesity will be studied in this tertiary care setting to determine the safety, effectiveness, and complication rates of mesh repair.

Materials and Methods: A prospective observational study was performed on 50 patients diagnosed with ventral hernia, each possessing at least one co-morbidity—either Type 2 diabetes mellitus or obesity (BMI ≥30 kg/m²). This study was conducted at the Department of General Surgery, Maharajahs Institute of Medical Sciences, Nellimarla, Vizianagaram District, Andhra Pradesh, India between March 2020 to February 2021. The research was conducted over an 18-month duration at a tertiary care institution. All patients received elective mesh repair with either the onlay or sublay approach. Preoperative optimization encompassed glycemic control and weight management therapy. The collected data encompassed intraoperative findings, repair type, length of hospital stay, complications, and recurrence over a 6-month follow-up period.

Results: Thirty patients had diabetes mellitus, twelve were obese, and eight had both conditions. An average of 51.6 years old with a standard deviation of 9.8 years was recorded. Of the patients seen, 32 had sublay repairs and 18 had onlays. Ten patients, or twenty percent, experienced problems after their operation. Infection of the wound occurred in seven cases (14% of the total), seroma formation in two (4%) and recurrence in one (2%) patient after six months were the next most prevalent complications. Wound infections were slightly more common in diabetic individuals (16.6%) than in obese patients who did not have diabetes (8.3%). Hospital stays averaged 5.0 ± 1.1 days. Adequate glycemic management and aseptic precautions allowed the majority of patients to have satisfactory wound healing and recoveries.

Conclusion: Patients with obesity and diabetes mellitus who undergo mesh hernia repairs with careful preoperative optimization and surgical technique have a good chance of a successful and safe outcome. In a controlled hospital environment, results are typically good, despite the fact that these populations have an elevated risk of complications, particularly those pertaining to wounds. This emphasizes how high-risk hernia patients require individualized perioperative care and the participation of other disciplines in their treatment.