Vacuum sealing drainage in the treatment of mesh infection following inguinal hernia repair_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Zhang ,  WU Yuquan

Department of Surgery, Huguosi Hospital of Beijing University of Chinese Medicine, Beijing 100035, P.R.China;

Corresponding author：

WU Yuquan, Email: wyq20020426@vip.qq.com

Keywords：

inguinal hernia; mesh infection; vacuum sealing drainage; curative effect

DOI：

10.7507/1007-9424.201607081

Video：

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Objective To observe the clinical effect of vacuum sealing drainage (VSD) in the treatment of mesh infection following inguinal hernia repair. Methods A total of 24 patients who suffered form mesh infection following inguinal hernia repair and got treatment in our hospital from February 2012 to December 2015 were collected and divided into 2 groups according to the type of treatment, 12 patients (13 sides) of VSD group received treatment of VSD, and 12 patients (13 sides) of conventional group received conventional treatment. Comparison between the 2 groups in mesh retention rate, the wound healing time, hospitalization cost, and hospital stay was performed. Results There was significant difference in mesh retention rate〔76.9% (10/13)vs. 30.8% (4/13)〕, the wound healing time〔(20.5±4.4) dvs. (29.7± 6.7) d〕, hospitalization cost〔(18 430.1±7 180.2) RMBvs. (12 201.1±6 453.2) RMB〕, and hospital stay〔(23.5±4.1) dvs. (30.7±6.5) d〕between the VSD group and conventional group (P<0.050). Compared with conventional group, the mesh retention rate and hospitalization cost were higher, the wound healing time and hospital stay were shorter in VSD group. Conclusions VSD can effectively control the mesh infection following hernia repair, improve the mesh retention rate. The VSD can also promote growth of granulation tissue in cavity, shorten the wound healing time and hospital stay, but has a high hospitalization cost than conventional treatment.

Citation： WU Zhang, WU Yuquan. Vacuum sealing drainage in the treatment of mesh infection following inguinal hernia repair. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(3): 361-365. doi: 10.7507/1007-9424.201607081 Copy

1.	方斌, 杨福全. 腹壁疝修补材料学研究进展. 中国实用外科杂志, 2015, 35(11): 1247-1250.
2.	中华医学会外科学分会疝和腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊疗指南(2014 年版). 中华疝和腹壁外科杂志(电子版), 2014, 8(3): 204-206.
3.	顾岩. 腹壁疝人工合成补片植入所致感染的防治. 外科理论与实践, 2010, 15(6): 586-589.
4.	李光学, 高锐星, 李尚俊, 等. 腹股沟疝无张力修补术后补片感染的临床分析. 中华疝和腹壁外科杂志: 电子版, 2016, 10(1): 66-67.
5.	Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery. Clin Microbiol Infect, 2005, 11(1): 3-8.
6.	Korenkov M, Sauerland S, Arndt M,et al. Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia. Br J Surg, 2002, 89(1): 50-56.
7.	陈杰. 重视腹外疝修补术后并发症的防治. 中国普外基础与临床杂志, 2013, 20(12): 1329-1332.
8.	Jacobs S, Simhaee DA, Marsano A,et al. Efficacy and mechanisms of vacuum-assisted closure (VAC) therapy in promoting wound healing: a rodent model. J Plast Reconstr Aesthet Surg, 2009, 62(10): 1331-1338.
9.	Fleischmann W, Strecker W, Bombelli M,et al. Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg, 1993, 96(9): 488-492.
10.	Morykwas MJ, Argenta LC, Shelton-Brown EI,et al. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg, 1997, 38(6): 553-562.
11.	中华人民共和国卫生部. 医院感染诊断标准(试行). 中华医学杂志, 2001, 81(5): 314-320.
12.	潘丽杰, 高春江, 周文莉. 切口疝补片修补感染的危险因素分析. 中华医院感染学杂志, 2015, 25(6): 1367-1371.
13.	杨先智. 腹股沟疝无张力修补术后切口感染的治疗. 中华医院感染学杂志, 2013, 23(12): 2881-2882.
14.	胡星辰, 唐健雄. 材料学的最新进展对疝修补的影响. 国际外科学杂志, 2015, 42(9): 577-579.
15.	陈思梦, 刘力嘉. 腹股沟疝术后感染及慢性疼痛临床处理. 中国实用外科杂志, 2014, 34(5): 398-400.
16.	时德, 赵渝. 疝修补材料特征与新概念. 中华疝和腹壁外科杂志(电子版), 2012, 6(1): 517-520.
17.	王小强, 李小军. 补片感染的诊断和处理原则. 中国实用外科杂志, 2008, 28(12): 1022-1024.
18.	杨林华, 陈涛, 王坚. 腹股沟嵌顿疝术后手术部位感染因素分析. 中国实用外科杂志, 2012, 32(12): 1043-1045.
19.	孙立, 申英末, 陈杰, 等. 腹股沟疝补片修补术后补片感染外科处理方法的研究. 中国普外基础与临床杂志, 2013, 20(12): 1341-1343.
20.	Plikaitis CM, Molnar JA. Subatmospheric pressure wound therapy and the vacuum-assisted closure device: basic science and current clinical successes. Expert Rev Med Device, 2006, 3(2): 175-184.
21.	裘华德, 宋九宏. 负压封闭引流技术. 北京: 人民卫生出版社, 2010: 5-6.
22.	吴坚, 罗兴良, 马树云, 等. 下肢骨折创面感染患者负压封闭引流治疗对下肢微循环及愈合的影响分析. 中华医院感染学杂志, 2016, 26(17): 3978-3980.
23.	余洪涛. VSD负压封闭引流技术在腹外疝修补术后早期切口感染中临床应用. 中华疝和腹壁外科杂志(电子版), 2015, 9(4): 337-339.
24.	宗振, 江志鹏, 侯泽辉, 等. 自制负压封闭引流装置治疗腹股沟疝术后补片感染疗效分析. 中国实用外科杂志, 2016, 36(5): 569-570.
25.	任群洲, 王晓明. 改良全封闭式持续负压术(VSD)在治疗中的应用. 中国社区医师(医学专业), 2010, (16): 74-75.
26.	Kenji N, Ihama Y, Fukasawa M,et al. Morphologic investigation of injury caused by locally applied negative pressure in a rat model. Leg Med (Tokyo), 2012, 14(1): 21-26.
27.	张玉, 崔恒心, 田娜, 等. VSD技术在肢体创面应用中并发症发生的原因分析及护理对策. 中国医疗前沿, 2011, 6(17): 69-70.

1. 方斌, 杨福全. 腹壁疝修补材料学研究进展. 中国实用外科杂志, 2015, 35(11): 1247-1250.
2. 中华医学会外科学分会疝和腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊疗指南(2014 年版). 中华疝和腹壁外科杂志(电子版), 2014, 8(3): 204-206.
3. 顾岩. 腹壁疝人工合成补片植入所致感染的防治. 外科理论与实践, 2010, 15(6): 586-589.
4. 李光学, 高锐星, 李尚俊, 等. 腹股沟疝无张力修补术后补片感染的临床分析. 中华疝和腹壁外科杂志: 电子版, 2016, 10(1): 66-67.
5. Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery. Clin Microbiol Infect, 2005, 11(1): 3-8.
6. Korenkov M, Sauerland S, Arndt M,et al. Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia. Br J Surg, 2002, 89(1): 50-56.
7. 陈杰. 重视腹外疝修补术后并发症的防治. 中国普外基础与临床杂志, 2013, 20(12): 1329-1332.
8. Jacobs S, Simhaee DA, Marsano A,et al. Efficacy and mechanisms of vacuum-assisted closure (VAC) therapy in promoting wound healing: a rodent model. J Plast Reconstr Aesthet Surg, 2009, 62(10): 1331-1338.
9. Fleischmann W, Strecker W, Bombelli M,et al. Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg, 1993, 96(9): 488-492.
10. Morykwas MJ, Argenta LC, Shelton-Brown EI,et al. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg, 1997, 38(6): 553-562.
11. 中华人民共和国卫生部. 医院感染诊断标准(试行). 中华医学杂志, 2001, 81(5): 314-320.
12. 潘丽杰, 高春江, 周文莉. 切口疝补片修补感染的危险因素分析. 中华医院感染学杂志, 2015, 25(6): 1367-1371.
13. 杨先智. 腹股沟疝无张力修补术后切口感染的治疗. 中华医院感染学杂志, 2013, 23(12): 2881-2882.
14. 胡星辰, 唐健雄. 材料学的最新进展对疝修补的影响. 国际外科学杂志, 2015, 42(9): 577-579.
15. 陈思梦, 刘力嘉. 腹股沟疝术后感染及慢性疼痛临床处理. 中国实用外科杂志, 2014, 34(5): 398-400.
16. 时德, 赵渝. 疝修补材料特征与新概念. 中华疝和腹壁外科杂志(电子版), 2012, 6(1): 517-520.
17. 王小强, 李小军. 补片感染的诊断和处理原则. 中国实用外科杂志, 2008, 28(12): 1022-1024.
18. 杨林华, 陈涛, 王坚. 腹股沟嵌顿疝术后手术部位感染因素分析. 中国实用外科杂志, 2012, 32(12): 1043-1045.
19. 孙立, 申英末, 陈杰, 等. 腹股沟疝补片修补术后补片感染外科处理方法的研究. 中国普外基础与临床杂志, 2013, 20(12): 1341-1343.
20. Plikaitis CM, Molnar JA. Subatmospheric pressure wound therapy and the vacuum-assisted closure device: basic science and current clinical successes. Expert Rev Med Device, 2006, 3(2): 175-184.
21. 裘华德, 宋九宏. 负压封闭引流技术. 北京: 人民卫生出版社, 2010: 5-6.
22. 吴坚, 罗兴良, 马树云, 等. 下肢骨折创面感染患者负压封闭引流治疗对下肢微循环及愈合的影响分析. 中华医院感染学杂志, 2016, 26(17): 3978-3980.
23. 余洪涛. VSD负压封闭引流技术在腹外疝修补术后早期切口感染中临床应用. 中华疝和腹壁外科杂志(电子版), 2015, 9(4): 337-339.
24. 宗振, 江志鹏, 侯泽辉, 等. 自制负压封闭引流装置治疗腹股沟疝术后补片感染疗效分析. 中国实用外科杂志, 2016, 36(5): 569-570.
25. 任群洲, 王晓明. 改良全封闭式持续负压术(VSD)在治疗中的应用. 中国社区医师(医学专业), 2010, (16): 74-75.
26. Kenji N, Ihama Y, Fukasawa M,et al. Morphologic investigation of injury caused by locally applied negative pressure in a rat model. Leg Med (Tokyo), 2012, 14(1): 21-26.
27. 张玉, 崔恒心, 田娜, 等. VSD技术在肢体创面应用中并发症发生的原因分析及护理对策. 中国医疗前沿, 2011, 6(17): 69-70.

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