Volume 9, Issue 4 (2025)
SJMR 2025, 9(4): 239-248 |
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Seyyedi S J. Innovative use of dual mesh in infants with diaphragmatic hernia: a case report. SJMR 2025; 9 (4) : 8
URL: http://saremjrm.com/article-1-354-en.html
URL: http://saremjrm.com/article-1-354-en.html
Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.Medical Sciences, Tehran, Iran
Abstract: (1067 Views)
Background and Objective: Congenital diaphragmatic hernia (CDH) is one of the most critical neonatal emergencies, often associated with severe pulmonary and cardiac complications, necessitating immediate surgical intervention. Managing intra-abdominal pressure (IAP) following the reduction of herniated abdominal viscera presents a major surgical challenge due to the limited capacity of the neonatal abdominal cavity. This study introduces and evaluates a novel surgical technique utilizing dual mesh reinforcement to minimize postoperative complications in neonates with CDH.
Methods: This case series includes 30 neonates with CDH operated between 2009 and 2024 at tertiary care hospitals. After returning the herniated viscera to the abdominal cavity, fascial release was performed, and a dual or physio mesh was placed directly on the fascia. Skin closure was achieved using an undermining technique, and Hemovac drains were inserted to prevent fluid accumulation. Postoperative outcomes, including complications such as infection, seroma formation, skin necrosis, and mortality rates, were systematically evaluated.
Results: The new technique resulted in excellent survival outcomes, with no mortality directly attributed to the surgical method. Only three cases experienced minor local complications, including erosion and mild infection, which were successfully managed with minimal intervention. Long-term follow-ups demonstrated satisfactory growth and quality of life in all patients.
Conclusion: The novel application of dual mesh for online fascial reinforcement and abdominal wall reconstruction in neonates with CDH appears to be a safe and effective technique. It offers a viable surgical alternative, especially in centers lacking advanced neonatal intensive care unit (NICU) facilities, significantly reducing morbidity and mortality rates.
Methods: This case series includes 30 neonates with CDH operated between 2009 and 2024 at tertiary care hospitals. After returning the herniated viscera to the abdominal cavity, fascial release was performed, and a dual or physio mesh was placed directly on the fascia. Skin closure was achieved using an undermining technique, and Hemovac drains were inserted to prevent fluid accumulation. Postoperative outcomes, including complications such as infection, seroma formation, skin necrosis, and mortality rates, were systematically evaluated.
Results: The new technique resulted in excellent survival outcomes, with no mortality directly attributed to the surgical method. Only three cases experienced minor local complications, including erosion and mild infection, which were successfully managed with minimal intervention. Long-term follow-ups demonstrated satisfactory growth and quality of life in all patients.
Conclusion: The novel application of dual mesh for online fascial reinforcement and abdominal wall reconstruction in neonates with CDH appears to be a safe and effective technique. It offers a viable surgical alternative, especially in centers lacking advanced neonatal intensive care unit (NICU) facilities, significantly reducing morbidity and mortality rates.
Article number: 8
Keywords: Congenital Diaphragmatic Hernia, Surgical Mesh, Abdominal Compartment Syndrome, Intra-Abdominal Pressure, Neonatal Intensive Care Units.
Article Type: Series Report |
Subject:
Childbirth
Received: 2025/01/14 | Accepted: 2025/02/8 | Published: 2025/03/25
Received: 2025/01/14 | Accepted: 2025/02/8 | Published: 2025/03/25
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