Spigelian Hernia
- In a frankly contaminated field, placement of a permanent mesh should be avoided. Primary repair should be performed or a biologic or absorbable synthetic mesh should be used.
- The best outcome in terms of reducing hernia recurrence involves placement of a permanent prosthetic mesh. Synthetic absorbable and biologic meshes are most often used in contaminated fields where infection is a concern but are associated with higher recurrence rates.
- Mesh reinforcement can be performed as an onlay, sublay, or underlay repair. In general, sublay or underlay mesh placement has been associated with lowest hernia recurrence rates.
