Background
Repair of giant incisional herniae is extremely challenging and more so in the face of surgical field contamination.

Material and Methods
This is a prospective cohort study of seven patients that were successfully treated through a multi-staged approach but in the same hospital admission, not described before, for the repair of primary & recurrent contaminated incisional herniae at a DGH between 2009 and 2013. Patient demographics, previous operations, complications & follow up were collected. The first stage involved the eradication of contamination and the second stage was the definitive hernia repair.

Results
Of the seven patients, five were men & two women with a mean age of 54 (34-74) years. Two patients had grade 4 while the remaining had grade 3 hernia as per the Hernia Grading System with a mean BMI of 35(30-46). All patients required extensive adhesiolysis, bowel resection and anastomosis and wash out. Hernial defect was measured as 204*(105-440) cm2, size of mesh implant was 568*(375-930) cm2 and the total duration of operation(1st + 2nd Stage) was 348*(270-540) minutes. Duration of hospital stay was 11*(7-19) days with a follow up of 24*(6- 48) months. 

Conclusion
Our multi-staged approach in the same hospital admission, for the repair of contaminated primary and recurrent giant incisional herniae, minimises the disadvantages of a true multi- staged approach and simultaneously minimises the risks & complications associated with a single-staged repair; can be adopted for these challenging patients for a successful outcome. 

* Median