clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2026-104-4-299-304clinmed-1460Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУGUIDELINES FOR PRACTITIONERSПрогнозирование раневых осложнений у больных с послеоперационными вентральными грыжами при имплантации сетчатых протезовPrediction of wound complications in patients with postoperative ventral hernias during implantation of mesh prostheseshttps://orcid.org/0000-0001-7079-8044ТарасоваН. К.TarasovaN. K.

Тарасова Надежда Константиновна – канд. мед. наук, доцент кафедры хирургии

Архангельск

Nadegda K. Tarasova – Candidate of Medical Sciences, Associate Professor

Arkhangelsk

nadegdatarasova73@mail.ruhttps://orcid.org/0000-0002-1720-6326ДыньковС. М.DynkovS. M.

Дыньков Сергей Михайлович – д-р мед. наук, профессор кафедры хирургии

Архангельск

Sergey M. Dynkov – Doctor of Medical Sciences, Professor of the Department of Surgery

Arkhangelsk

https://orcid.org/0000-0002-6804-3790МизгиревД. В.MizgirevD. V.

Мизгирев Денис Владимирович – д-р мед. наук, профессор кафедры хирургии

Архангельск

Denis V. Mizgirev – Doctor of Medical Sciences, Professor of the Department of Surgery, surgeon

Arkhangelsk

https://orcid.org/0009-0008-8428-8588КоровинаТ. Ю.KorovinaT. Yu.

Коровина Татьяна Юрьевна – студентка 6-го курса лечебного факультета

Архангельск

Tatyana Yu. Korovina – sixth-year student, Faculty of General Medicine

Arkhangelsk

https://orcid.org/0009-0000-6867-2805ШадринаВ. С.ShadrinaV. S.

Шадрина Варвара Сергеевна – студентка 6-го курса лечебного факультета

Архангельск

Varvara S. Shadrina – sixth-year student, Faculty of General Medicine

Arkhangelsk

ФГБОУ ВО «Северный государственный медицинский университет» Минздрава России; ГБУЗ АО «Первая городская клиническая больница им. Е.Е. Волосевич»РоссияNorthern State Medical University of the Ministry of Healthcare of the Russia; First Clinical City Hospital named after E.E. VolosevichRussian FederationФГБОУ ВО «Северный государственный медицинский университет» Минздрава РоссииРоссияNorthern State Medical University of the Ministry of Healthcare of the RussiaRussian Federation2026200620261044299304Copyright © Тарасова Н.К., Дыньков С.М., Мизгирев Д.В., Коровина Т.Ю., Шадрина В.С., 20262026Тарасова Н.К., Дыньков С.М., Мизгирев Д.В., Коровина Т.Ю., Шадрина В.С.Tarasova N.K., Dynkov S.M., Mizgirev D.V., Korovina T.Y., Shadrina V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/1460

Для хирургического лечения послеоперационных вентральных грыж используются сетчатые протезы, что становится дополнительным фактором риска раневых осложнений. Цель: определить предикторы раневых осложнений у больных с послеоперационными вентральными грыжами после имплантации сетчатых протезов. Материал и методы. Выполнено проспективное исследование 50 пациентов с послеоперационными вентральными грыжами, которым имплантированы сетчатые протезы. Пациенты разделены на 2 группы: первая группа состояла из 39 (78%) больных без раневых осложнений, вторая группа представлена 11 (22%) пациентами, у которых развились раневые осложнения. У всех больных изучены дооперационные и послеоперационные предикторы раневых осложнений, а также проведено исследование общего анализа крови, С-реактивного белка, альбумина и ферритина до операции и на 3-и сутки послеоперационного периода. Результаты. Дооперационные предикторы раневых осложнений: возраст, сопутствующие заболевания и размер грыжи не имели статистической достоверности. Такие критерии, как время операции более 2 часов, постановка дренажей более 8 суток с суточной экссудацией из раны более 100 мл были достоверными. Среди индикаторов воспаления статистически значимыми оказались альбумин и ферритин (p = 0,010). В группе с раневыми осложнениями отмечалось снижение альбумина до 35,4 ± 1,8 г/л, и увеличение ферритина до 357,7 ± 50,5 мкг/л. Выводы. Для своевременной диагностики раневых осложнений у больных с послеоперационными вентральными грыжами возможно исследование альбумина и ферритина как достоверных маркеров воспаления после аллопластических операций.

Mesh prostheses are used for surgical treatment of postoperative ventral hernias, which becomes an additional risk factor for wound complications. Aim: to determine predictors of wound complications in patients with postoperative ventral hernias after implantation of mesh prostheses. Material and methods. A prospective study of 50 patients with postoperative ventral hernias who underwent mesh implantation was conducted. The patients were divided into two groups: the first group consisted of 39 patients (78%) without wound complications, and the second group consisted of 11 patients (22%) who developed wound complications. Preoperative and postoperative predictors of wound complications were assessed in all patients, as well as complete blood count, C-reactive protein, albumin, and ferritin levels before surgery and on the third postoperative day. Results. Preoperative predictors of wound complications, including age, comorbidities, and hernia size, were not statistically significant. Criteria such as operative time greater than 2 hours, drainage for more than 8 days, and daily wound exudation greater than 100 ml were significant. Among inflammation indicators, albumin and ferritin were statistically significant (p = 0,010). In the group with wound complications, albumin decreased to 35,4 ± 1,8 g/L, and ferritin increased to 357,7 ± 50,5 μg/L. Leukocyte, lymphocyte, neutrophil, monocyte, and C-reactive protein counts were not statistically significant. Conclusions. Thus, for the timely diagnosis of wound complications in patients with postoperative ventral hernias, it is possible to study albumin and ferritin as reliable markers of inflammation after alloplastic operations.

послеоперационная вентральная грыжасетчатый протезраневые осложненияпредикторы осложненийальбуминферритинС-реактивный белокpostoperative ventral herniamesh prosthesiswound complicationspredictors of complicationsalbuminferritinC-reactive proteinReferencesWilson R.B., Farooque Y. Risks and prevention of surgical site infection after hernia mesh repair and the predictive utility of ACS-NSQIP. Journal of Gastrointestinal Surgery. 2022;26:950–964. DOI: 10.1007/s11605-022-05248-6Wilson R.B., Farooque Y. Risks and prevention of surgical site infection after hernia mesh repair and the predictive utility of ACS-NSQIP. Journal of Gastrointestinal Surgery. 2022;26:950–964. DOI: 10.1007/s11605-022-05248-6Talpai T., Râmboiu D.S., Pîrvu C.A., Pantea S., Șelaru M., Cârțu D. et al. A comparison of open ventral hernia repair risk stratification systems: a call for consensus. Journal of Clinical Medicine. 2024;13(22):6692. DOI: 10.3390/jcm13226692Talpai T., Râmboiu D.S., Pîrvu C.A., Pantea S., Șelaru M., Cârțu D. et al. A comparison of open ventral hernia repair risk stratifi cation systems: a call for consensus. Journal of Clinical Medicine. 2024;13(22):6692. DOI: 10.3390/jcm13226692Pochhammer J., Scholtes B., Keuler J., Müssle B., Welsch T., Schäffer M. Serum C-reactive protein level after ventral hernia repair with mesh reinforcement can predict infectious complications: a retrospective cohort study. Hernia. 2020;24(1):41–48. DOI: 10.1007/s10029-018-1844-7Pochhammer J., Scholtes B., Keuler J., Müssle B., Welsch T., Schäff er M. Serum C-reactive protein level after ventral hernia repair with mesh reinforcement can predict infectious complications: a ret- rospective cohort study. Hernia. 2020;24(1):41–48. DOI: 10.1007/s10029-018-1844-7Labgaa I., Joliat G-R., Kefleyesus A., Mantziari S., Schäfer M., Demartines N., Hübner M. Is postoperative decrease of serum albumin an early predictor of complications after major abdominal surgery? A prospective cohort study in a European centre. British Medical Journal Open. 2017;7(4):e013966. DOI: 10.1136/bmjop-en-2016-013966Labgaa I., Joliat G-R., Kefl eyesus A., Mantziari S., Schäfer M., Demartines N., Hübner M. Is postoperative decrease of serum albumin an early predictor of complications after major abdominal surgery? A prospective cohort study in a European centre. British Medical Journal Open. 2017;7(4):e013966. DOI: 10.1136/bmjop-en-2016-013966Janet J., Derbal S., Durand Fontanier S., Bouvier S., Christou N., Fabre A. et al. C-reactive protein is a predictive factor for complications after incisional hernia repair using a biological mesh. Science Report. 2021;11(1):4379. DOI: 10.1038/s41598-021-83663-6Janet J., Derbal S., Durand Fontanier S., Bouvier S., Christou N., Fabre A. et al. C-reactive protein is a predictive factor for complications after incisional hernia repair using a biological mesh. Science Report. 2021;11(1):4379. DOI: 10.1038/s41598-021-83663-6Lorenz W.R., Holland A.M., Sarac B.A., Kerr S.W., Wilson H.H., Ayuso S.A. et al. Development of multicenter deep learning models for predicting surgical complexity and surgical site infection in abdominal wall reconstruction, a pilot study. Journal of Abdominal Wall Surgery. 2025;4:14371. DOI: 10.3389/jaws.2025.14371Lorenz W.R., Holland A.M., Sarac B.A., Kerr S.W., Wilson H.H., Ayuso S.A. et al. Development of multicenter deep learning models for predicting surgical complexity and surgical site infection in abdominal wall reconstruction, a pilot study. Journal of Abdominal Wall Surgery. 2025;4:14371. DOI: 10.3389/jaws.2025.14371Plymale M.A., Harris J.W., Davenport D.L., Smith N., Levy S., Scott Roth J. Abdominal wall reconstruction: the uncertainty of the impact of drain duration upon outcomes. The American Journal of Surgery. 2016;82(3):207–211. PMID: 27099055Plymale M.A., Harris J.W., Davenport D.L., Smith N., Levy S., Scott Roth J. Abdominal wall reconstruction: the uncertainty of the impact of drain duration upon outcomes. The American Journal of Surgery. 2016;82(3):207–211. PMID: 27099055Кузнецов А.В., Костина Л.Ю., Новикова А.И. и др. Выбор адекватного способа дренирования парапротезной полости в лечении послеоперационных вентральных грыж. Сибирский медицинский вестник. 2021;3:44–47.[Kuznetsov А.V., Kostina L.Yu., Novikov A.I. et al. Selection of an adequate method for draining prosthetic cavity in the treatment of postoperative ventral hernias. Sibirskiy meditsinskiy Vestnik. 2021;3:44–47. (In Russ/)]. DOI: 10.31549/2541-8289-2021-3-44-47Patiniott P., Jacombs A., Kaul L., Hu H., Warner M., Klosterhalfen B., Karatassas A., Maddern G, Richter K. Are late hernia mesh complications linked to Staphylococci biofilms? Hernia. 2022;26(5):1293–1299. DOI: 10.1007/s10029-022-02583-0Patiniott P., Jacombs A., Kaul L., Hu H., Warner M., Klosterhalfen B., Karatassas A., Maddern G, Richter K. Are late hernia mesh complications linked to Staphylococci biofi lms? Hernia. 2022;26(5):1293–1299. DOI: 10.1007/s10029-022-02583-0He L., Wang X., Fan G., Zhao Y. Hernia mesh infection treatment following the repair of abdominal wall hernias: A single-center experience. Frontiers in Surgery.2022;9:993855. DOI: 10.3389/fsurg.2022.993855He L., Wang X., Fan G., Zhao Y. Hernia mesh infection treatment following the repair of abdominal wall hernias: A single-center experience. Frontiers in Surgery.2022;9:993855. DOI: 10.3389/ fsurg.2022.993855Hübner M., Mantziari S., Demartines N., Pralong F., Coti-Bertrand P., Schäfer M. Postoperative albumin drop is a marker for surgical stress and a predictor for clinical outcome: a pilot study. Gastroenterology Research and Practice. 2016;2016:8743187. DOI: 10.1155/2016/8743187Hübner M., Mantziari S., Demartines N., Pralong F., Coti-Bertrand P., Schäfer M. Postoperative albumin drop is a marker for surgical stress and a predictor for clinical outcome: a pilot study. Gastroenterology Research and Practice. 2016;2016:8743187. DOI: 10.1155/2016/8743187Bouvier A., Fournel I., Charles P.E., Rat P., Ortega-Deballon P; IMACORS Study. Diagnostic accuracy of inflammatory markers as early predictors of infection after elective colorectal surgery: results from the IMACORS Study. Annals of Surgery. 2016;263(5):961–6. DOI: 10.1097/SLA.0000000000001303Bouvier A., Fournel I., Charles P.E., Rat P., Ortega-Deballon P; IMACORS Study. Diagnostic accuracy of infl ammatory markers as early predictors of infection after elective colorectal surgery: results from the IMACORS Study. Annals of Surgery. 2016;263(5):961–6. DOI: 10.1097/SLA.0000000000001303Kumar S., Baitha K.S., Dev A., Prakash P., Gunjan G. Correlation between postoperative complications and serum albumin levels in abdominal surgery: a prospective observational study. Cureus. 2025;17(6):e86508. DOI: 10.7759/cureus.86508Kumar S., Baitha K.S., Dev A., Prakash P., Gunjan G. Correlation between postoperative complications and serum albumin levels in abdominal surgery: a prospective observational study. Cureus. 2025;17(6):e86508. DOI: 10.7759/cureus.86508Mintziras I., Maurer E., Kanngiesser V., Bartsch D.K. C-reactive protein and drain amylase accurately predict clinically relevant pancreatic fistula after partial pancreaticoduodenectomy. International Journal of Surgery. 2020;76:53–58. DOI: 10.1016/j.ij-su.2020.02.025Mintziras I., Maurer E., Kanngiesser V., Bartsch D.K. C-reactive protein and drain amylase accurately predict clinically relevant pancreatic fi stula after partial pancreaticoduodenectomy. International Journal of Surgery. 2020;76:53–58. DOI: 10.1016/j.ij-su.2020.02.025FitzGerald J.F., Kumar A.S.. Biologic versus synthetic mesh reinforcement: What are the pros and cons? Clinics in Colon and Rectal Surgery. 2014;27:140–148. DOI: 10.1055/s-0034-1394155FitzGerald J.F., Kumar A.S.. Biologic versus synthetic mesh reinforcement: What are the pros and cons? Clinics in Colon and Rectal Surgery. 2014;27:140–148. DOI: 10.1055/s-0034-1394155Labgaa I., Demartines N., Hübner M. Biomarkers Capable to Early Predict Postoperative Complications: The Grail. Annals of Surgery. 2017;266(6):e91–e92. DOI: 10.1097/SLA.0000000000001771Labgaa I., Demartines N., Hübner M. Biomarkers Capable to Early Predict Postoperative Complications: The Grail. Annals of Surgery. 2017;266(6):e91–e92. DOI: 10.1097/SLA.0000000000001771Joliat G.R., Schoor A., Schäfer M., Demartines N., Hübner M., Labgaa I. Postoperative decrease of albumin (ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review. Perioperative medicine. (Lond). 2022;11(1):7. DOI: 10.1186/s13741-022-00238-3Joliat G.R., Schoor A., Schäfer M., Demartines N., Hübner M., Labgaa I. Postoperative decrease of albumin (ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review. Perioperative medicine. (Lond). 2022;11(1):7. DOI: 10.1186/s13741-022-00238-3Labgaa I., Mantziari S., Genety M. Early postoperative decrease of albumin is an independent predictor of major complications after oncological esophagectomy: a multicenter study. Journal of Surgical Oncology. 2021;123(2):462–469. DOI: 10.1002/jso.26317Labgaa I., Mantziari S., Genety M. Early postoperative decrease of albumin is an independent predictor of major complications after oncological esophagectomy: a multicenter study. Journal of Surgical Oncology. 2021;123(2):462–469. DOI: 10.1002/jso.26317Шатохин Ю.В., Снежко И.В., Бурнашева Е.В., Рябикина Е.В., Дегтерева Е.В. Значение исследования ферритина в клинической практике (лекция для практикующих врачей). Южно-Российский журнал терапевтической практики. 2024;5(3):102–113.[Shatokhin Yu.V., Snezhko I.V., Burnasheva E.V., Ryabikina E.V., Degtereva E.V. The importance of ferritin research in clinical practice (lecture for practicing physicians). Yuzhno-Rossiyskiy zhurnal terapevticheskoy praktiki. 2024;5(3):102–113. (In Russ.)]. DOI: 10.21886/2712-8156-2024-5-3-102-113Зурнаджьянц В.А., Бондарева В.А., Кчибеков Э.А., Зурнаджьянц А.В. Ферропротеины в диагностике воспалительного процесса в ране при грыжах передней брюшной стенки. Научные ведомости Белгородского Государственного университета. Серия Медицина. Фармация. 2014;4(175):32–34.[Zurnadzhy- ants V.A., Bondareva V.A., Kchibekov E.A., Zurnadzhyants A.V. Ferroproteins in diagnostics of the infl ammatory process in the wound of hernias of the anterior abdominal wall. Nauchnye vedomosti Belgorodskogo Gosudarstvennogo Universiteta. Series Medicine. Pharmacy. 2014;4(175):32–34. (In Russ.)]. УДК: 617.55-007.43-001.4-07Каледа М.И., Федоров Е.С. Значение гиперферритинемии как диагностического и прогностического биомаркера. Современная ревматология. 2022;16(2):74–80.[Kaleda M.I., Fedorov E.S. The importance of hyperferritinemia as a diagnostic and prognostic biomarker. Sovremennaya revmatologiya. 2022;16(2):74–80. (In Russ.)]. DOI: 10.14412/1996-7012-2022-2-74-80

The authors declare that there are no conflicts of interest present.