The dissertation is dedicated to the improvement of surgical treatment of midline postoperative incisional hernias, in particular reducing recurrence and postoperative complication rates by means of optimizing appropriate allohernioplasty method selection which based on new method of allohernioplasty development, selection of mesh implant and postoperative complications prevention. Results of experimental studies carried out on 50 rats have disclosed that "onlay" placement of mesh implant leads to connective tissue capsule formation around mesh implant in the way of overgrowth of coarse-fibered connective tissue with inflammation focuses. Thin-layer connective tissue capsule with even intergrowth of mesh implant is formed when mesh implant is placed using "sublay" method. Clinical studies have been performed involving 230 patients presented with midline postoperative incisional hernias of different size. Depending on the performed alloplasty method patients were divided into three groups. "Onlay" method was used in the first group (79 patients) with implantation of polypropylene implant. Traditional "sublay" method using composite mesh (41 patients) and polypropylene mesh (38 patients) has been used in the second studying group (total 79 patients). Improved "sublay" method using "light" mesh has been performed in the third group (72 patients). "Sublay" method has substantial advantages against "onlay". Wound complications rate: seroma formation when using "onlay" constitutes 29,1% against 15,8% when using "sublay", sequentially inflammatory infiltrate - 12,65% against 10,5%, wound infection- 6,3% against 2,6%, abdominal wall fistulas - 4,4% against 0%, chronic pain - 15,5% against 12,5%, reccurence rate - 11,1% against 8,3%. Early and late results of allohernioplasty of midline postoperative incisional hernias after modified "sublay" method with "light" mesh implant have shown reduced rate of wound complications, seroma formation has reduced from 9,7% to 4,2%, wound infection from 2,4% to 1,4%, chronic pain from 4,3% to 1,8%, recurrence rate in from 8,5% to 1,8%.
