Comparison of early complications using regular mesh versus Atramat® Neoflex 25 mesh in inguinal, umbilical and post incisional hernias


  • Juan José Granados-Romero Cirugía General, Hospital General de México
  • Alan Isaac Valderrama-Treviño Departamento de Cirugía, Facultad de Medicina, UNAM
  • Germán Eduardo Mendoza-Barrera Departamento de Cirugía, Facultad de Medicina, UNAM
  • Jesús Carlos Ceballos-Villalva AFINES, Facultad de Medicina, UNAM
  • Aranza Guadalupe Estrada-Mata AFINES, Facultad de Medicina, UNAM
  • Carlos Aarón Méndez Celis Departamento de Cirugía, Facultad de Medicina, UNAM
  • José Javier Romo García Facultad de Medicina, La Salle
  • Ericka Hazzel Contreras-Flores AFINES, Facultad de Medicina, UNAM



Inguinal hernia, Surgery, Surgical mesh, Absorbable mesh, Treatment outcome


Background: Hernias are one of the most common reasons of primary health care with subsequent surgery and this has led to search new techniques to approach them. Comparing traditional techniques with polypropylene mesh versus one bioabsorbible mesh there has been a decrease in postoperative complications.

Methods: 100 patients with inguinal hernia, umbilical and post incisional were surgically intervened and divided into two groups according to mesh material used. The patients were tracked for two months after surgery.

Results: Traditional mesh was used to repair hernias in 50 patients and Atramat® Neoflex 25 mesh was used in the other half.  Two patients developed infection with traditional mesh and one patient using Atramat® Neoflex 25 mesh (p 0.558). Hernias recurred in 4 patients with traditional mesh compared with 0 patients with Atramat® Neoflex 25 mesh ( p.041 ) , seroma formation was found with a 6: 1 ratio, traditional mesh: Atramat® Neoflex 25 mesh ( p.050 ) and hematoma in a 2:1 ratio (p .558). The total of complications showed a total of 14 using traditional mesh and 3 with Atramat® Neoflex 25 mesh. The use of mesh made from absorbable materials is a better alternative to reduce chronic pain and recurrence due to its high biocompatibility.

Conclusions: Using Atramat® Neoflex 25 mesh demonstrated a significant reduction of complications (recurrence and seroma formation) and length of hospital stay (2 days vs 1 day in abdominoplasty after surgery).   



Ein S, Njere I, Ein A. Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review. J Pediatr Surg. 2006;41:980-6.

Burcharth J. The epidemiology and risk factors for recurrence after inguinal hernia surgery. Dan Med J. 2014;61(5):1-17.

Ruhl CE, Everhart JE. Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol. 2007;165:1154-61.

Zhong C, Wu B, Yang Z, Deng X, Kang J, Guo B. A metaanalysis comparing lightweight meshes with heavyweight meshes in Lichtenstein inguinal hernia repair. Surg Innov. 2013;20:24-31.

Van der Pool AEM, Harlaar JJ, Den Hoed PT, Weidema WF, Van Veen RN. Long-term follow-up evaluation of chronic pain after endoscopic total extraperitoneal repair of primary and recurrent inguinal hernia.Surg Endosc. 2010;24:1707-11.

Asociación Mexicana de Cirugía General. GPC Tratamiento de la hernia inguinal en el adulto. México. 2014.

Adel Eldabe Mickail, Alberto Palomo Luquero, José Felipe Reoyo, Pascual Seco Gil. Fijación del material protésico en la hernioplastía inguinal abierta: sutura vs cola sintética.Cir Esp. 2012;90(7):446-52.

Smigielski J, Brocki M, Kuzdak K, Kołomecki K. Serum MMP 2 and TIMP 2 in patients with inguinal hernias. Eur J Clin Invest. 2011;41:584-8.

Burcharth J, Rosenberg J. Gastrointestinal surgery and related complications in patients with Ehlers-Danlos syndrome: a systematic review. Dig Surg. 2012;29:349-57.

Bischoff J, Linderoth G, Aasvang E, Werner M, Kehlet H. Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study. Surg Endosc. 2012;26:979-83.

Lundstrum K, Sandblom G, Smedberg S, Nordin P. Risk factors for complications in groin hernia surgery: a national register study. Ann Surg. 2012;255:784-8.

Saga I. Actualidades en hernia inguinal, estado del arte. Cir Gral. 2005;7(2):164-7.

Elsebae M, Nasr M, Said M. Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study. IJS. 2008;6(4):302-5.

Ignacio J, Luis G. Resultados a largo plazo de plastía inguinal. Cir Gral. 2012;34(1):20-2.

Read R. Herniology: Past, present and future. Hernia. 2009;13(6):577-80.

Agarwal BB. Inguinal Hernia Repair Challenges Beyond Zero Recurrence. Saudi J Gastroenterol. 2010:16(1):1-2.

Dennis R, O´Riordan D. Risk Factors for Chronic Pain After Inguinal Hernia Repair, Ann R Coll Surg Engl. 2007;89(3):218-20.

Mattias W, Reinpold J, Nehls J, Eggert A. Nerve Management and chronic pain after open inguinal hernia repair. Annals of Surgery. 2011:254(1):163-8.

Bilsel Y, Abci I. The search for ideal hernia repair; mesh materials and types. IJS. 2012;10(6):317-21.

The EU Hernia Trialists Collaboration. Repair of Groin Hernia With Synthetic Mesh Meta-Analysis of Randomized Controlled Trials. ANNALS OF SURGERY. 2002;235,(3):322.

Fallis SA, Taylor LH, Tiramularaj RMR. Biological mesh repair of a strangulated perineal hernia following abdominoperineal resection. JSCR. 2013;3:1-3.

Douek M, Smith G, Oshowo A, Stoker DL, Wellwood JM. Prospective randomised controlled trial of laparoscopic versus open inguinal hernia mesh repair: five year follow up. BMJ. 2003;326:1012-1013.

Zhao G, Gao P, Ma B, Tian J. Open Mesh Techniques for inguinal Hernia Repair: A Meta-analysis of Randomized Controlled Trials. ANN Surg. 2009;250:35-42.

Bakytbekovich N, Yermukhambetovichzha ZZ. Modified tension-free mesh repair used in rare case of Littre’s hernia. IJS Case Reports. 2015;12:81-3.




How to Cite

Granados-Romero, J. J., Valderrama-Treviño, A. I., Mendoza-Barrera, G. E., Ceballos-Villalva, J. C., Estrada-Mata, A. G., Méndez Celis, C. A., García, J. J. R., & Contreras-Flores, E. H. (2016). Comparison of early complications using regular mesh versus Atramat® Neoflex 25 mesh in inguinal, umbilical and post incisional hernias. International Journal of Research in Medical Sciences, 4(1), 194–197.



Original Research Articles