Surgical Treatment for Mesh Infection after Prosthetic Patch Repair of Inguinal Hernia_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Li ¹ ,  SHEN Yingmo ¹ , CHEN Jie ¹ , LIU Sujun ¹ , CHEN Fuqiang ¹ , YANG Guiyue ²

1.Department of Hernia and Abdominal Wall Surgery， Beijing Chao-Yang Hospital， Capital Medical University， Beijing 100043， China;;
2.Department of Medical Record and Statistics， Beijing Chao-Yang Hospital， Capital Medical University， Beijing 100043， China;

Corresponding author：

SHEN Yingmo, Email: shenyingmo@126.com

Keywords：

Mesh infection; Inguinal hernia; Herniorrhaphy; Surgical treatment

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Objective 　To discuss the surgical treatment and experience of mesh infection after prosthetic patch repair of inguinal hernia.
Methods 　The clinical data of 67 cases of mesh infection after prosthetic patch repair who were treated in Chao-Yang Hospital from Jan. 2011 to Jun. 2012 were retrospectively analyzed.
Results 　All patients were treated with surgical operation successfully， including removing the infected mesh and surrounding tissues， primary suture， and a placement of wound drainage， without replacement of a new patch substitute. The hospital stay of the patients was 10-25days with an average of 16days. Of the 67 patients， 51 patients got primary healed and the other 16 patients healed delayed after local dressing change due to the superficial infection following stitch removal. Sixty-six patients were followed-up for 6-24 months （average of 20 months） after operation without recurrence and complication， including seroma， wound infection， intestinal fistula， and postoperative pain.
Conclusions 　The treatment of mesh infection after inguinal hernia repair is very complicated， but the primary suture repair and a placement of wound drainage after removing infected mesh with complete debridement is a effective therapy for it.

Citation： SUN Li,SHEN Yingmo,CHEN Jie,LIU Sujun,CHEN Fuqiang,YANG Guiyue. Surgical Treatment for Mesh Infection after Prosthetic Patch Repair of Inguinal Hernia. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(12): 1341-1343. doi: Copy

1.	申英末，陈杰，王振军，等. 疝修补材料的发展与新进展[J]. 中华疝和腹壁外科杂志：电子版， 2007， 1(1)：56-59.
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7.	朱健. 腹股沟疝无张力修补的认识进展[J]. 实用医学杂志， 2005， 21(2)：215-216.
8.	Salvilla SA， Thusu S， Panesar SS. Analysing the benefits of lapa-roscopic hernia repair compared to open repair：a meta-analysis of observational studies[J]. J Minim Access Surg， 2012， 8(4)：111-117.
9.	Penttinen R， Grönroos JM. Mesh repair of common abdominal hernias：a review on experimental and clinical studies[J]. Hernia，2008， 12(4)：337-344.
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11.	Brown RH， Subramanian A， Hwang CS， et al. Comparison of infectious complications with synthetic mesh in ventral hernia repair[J]. Am J Surg， 2013， 205(2)：182-187.
12.	Hawn MT， Gray SH， Snyder CW， et al. Predictors of mesh expl-antation after incisional hernia repair[J]. Am J Surg， 2011， 202(1)：28-33.
13.	Zuvela M， Antic A， Bajec D， et al. Diagnosis of mesh infectionafter abdominal wall hernia surgery—role of radionuclide methods[J]. Hepatogastroenterology， 2011， 58(110-111)：1455-1460.
14.	Blatnik JA， Krpata DM， Novitsky YW， et al. Does a history of wound infection predict postoperative surgical site infection after ventral hernia repair?[J]. Am J Surg， 2012， 203(3)：370-374.
15.	Cobb WS， Carbonell AM， Kalbaugh CL， et al. Infection risk of open placement of intraperitoneal composite mesh[J]. Am Surg， 2009， 75(9)：762-767.
16.	Aguilar B， Chapital AB， Madura JA， et al. Conservative manag-ement of mesh-site infection in hernia repair[J]. J Laparoendosc Adv Surg Tech A， 2010， 20(3)：249-252.
17.	Eriksen JR， Gögenur I， Rosenberg J. Choice of mesh for laparoscopic ventral hernia repair[J]. Hernia， 2007， 11(4)：481-492.
18.	Hawn MT， Snyder CW， Graham LA， et al. Long-term follow-upof technical outcomes for incisional hernia repair[J]. J Am Coll Surg， 2010， 210(5)：648-655.
19.	Sabbagh C， Verhaeghe P， Brehant O， et al. Partial removal of infected parietal meshes is a safe procedure[J]. Hernia， 2012， 16(4)：445-449.
20.	Greenberg JJ. Can infected composite mesh be salvaged?[J]. Hernia， 2010， 14(6)：589-592.
21.	Halaweish I， Harth K， Broome AM， et al. Novel in vitro model for assessing susceptibility of synthetic hernia repair meshes to staphylococcus aureus infection using green fluorescent protein-labeled bacteria and modern imaging techniques[J]. Surg Infect (Larchmt)， 2010， 11(5)：449-454.
22.	Tolino MJ， Tripoloni DE， Ratto R， et al. Infections associated with prosthetic repairs of abdominal wall hernias：pathology， management and results[J]. Hernia， 2009， 13(6)：631-637.
23.	Miller G. Promising agent emerging to battle mesh infections[J]. Gen Surg News， 2010， 37(1)：16-17.
24.	杨帆. 无张力疝修补术后并发症分析[J]. 中华疝和腹壁外科杂志：电子版， 2013， 7(1)：7-9.
25.	李基业. 腹壁切口疝合成补片修补的感染原因及防治[J]. 外科理论与实践， 2013， 18(3)：202-206.

1. 申英末，陈杰，王振军，等. 疝修补材料的发展与新进展[J]. 中华疝和腹壁外科杂志：电子版， 2007， 1(1)：56-59.
2. 孙立，陈杰，申英末，等. 精索护垫补片在腹股沟疝修补术中的应用研究[J]. 中国现代医学杂志， 2012， 22(31)：101-104.
3. 顾岩. 腹壁疝人工合成补片植入所致感染的防治[J]. 外科理论与实践， 2010， 15(6)：586-589.
4. 刘飞德，李基业，姚胜，等. 腹壁疝补片修补术后感染的外科处理[J]. 中国普外基础与临床杂志， 2011， 18(12)：1292-1295.
5. 陈健民，刘谊和，郑涵予. 无张力疝修补术后切口感染分析[J]. 中华疝和腹壁外科杂志：电子版， 2008， 2(3)：334-336.
6. Jezupovs A， Jezupors A， Mihelsons M. The analysis of infection after polypropylene mesh repair of abdominal wall hernia[J]. World J Surg， 2006， 30(12)：2270-2278.
7. 朱健. 腹股沟疝无张力修补的认识进展[J]. 实用医学杂志， 2005， 21(2)：215-216.
8. Salvilla SA， Thusu S， Panesar SS. Analysing the benefits of lapa-roscopic hernia repair compared to open repair：a meta-analysis of observational studies[J]. J Minim Access Surg， 2012， 8(4)：111-117.
9. Penttinen R， Grönroos JM. Mesh repair of common abdominal hernias：a review on experimental and clinical studies[J]. Hernia，2008， 12(4)：337-344.
10. Alaedeen DI， Lipman J， Medalie D， et al. The single-staged approach to the surgical management of abdominal wall hernias in contaminated fields[J]. Hernia， 2007， 11(1)：41-45.
11. Brown RH， Subramanian A， Hwang CS， et al. Comparison of infectious complications with synthetic mesh in ventral hernia repair[J]. Am J Surg， 2013， 205(2)：182-187.
12. Hawn MT， Gray SH， Snyder CW， et al. Predictors of mesh expl-antation after incisional hernia repair[J]. Am J Surg， 2011， 202(1)：28-33.
13. Zuvela M， Antic A， Bajec D， et al. Diagnosis of mesh infectionafter abdominal wall hernia surgery—role of radionuclide methods[J]. Hepatogastroenterology， 2011， 58(110-111)：1455-1460.
14. Blatnik JA， Krpata DM， Novitsky YW， et al. Does a history of wound infection predict postoperative surgical site infection after ventral hernia repair?[J]. Am J Surg， 2012， 203(3)：370-374.
15. Cobb WS， Carbonell AM， Kalbaugh CL， et al. Infection risk of open placement of intraperitoneal composite mesh[J]. Am Surg， 2009， 75(9)：762-767.
16. Aguilar B， Chapital AB， Madura JA， et al. Conservative manag-ement of mesh-site infection in hernia repair[J]. J Laparoendosc Adv Surg Tech A， 2010， 20(3)：249-252.
17. Eriksen JR， Gögenur I， Rosenberg J. Choice of mesh for laparoscopic ventral hernia repair[J]. Hernia， 2007， 11(4)：481-492.
18. Hawn MT， Snyder CW， Graham LA， et al. Long-term follow-upof technical outcomes for incisional hernia repair[J]. J Am Coll Surg， 2010， 210(5)：648-655.
19. Sabbagh C， Verhaeghe P， Brehant O， et al. Partial removal of infected parietal meshes is a safe procedure[J]. Hernia， 2012， 16(4)：445-449.
20. Greenberg JJ. Can infected composite mesh be salvaged?[J]. Hernia， 2010， 14(6)：589-592.
21. Halaweish I， Harth K， Broome AM， et al. Novel in vitro model for assessing susceptibility of synthetic hernia repair meshes to staphylococcus aureus infection using green fluorescent protein-labeled bacteria and modern imaging techniques[J]. Surg Infect (Larchmt)， 2010， 11(5)：449-454.
22. Tolino MJ， Tripoloni DE， Ratto R， et al. Infections associated with prosthetic repairs of abdominal wall hernias：pathology， management and results[J]. Hernia， 2009， 13(6)：631-637.
23. Miller G. Promising agent emerging to battle mesh infections[J]. Gen Surg News， 2010， 37(1)：16-17.
24. 杨帆. 无张力疝修补术后并发症分析[J]. 中华疝和腹壁外科杂志：电子版， 2013， 7(1)：7-9.
25. 李基业. 腹壁切口疝合成补片修补的感染原因及防治[J]. 外科理论与实践， 2013， 18(3)：202-206.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Surgical Treatment for Mesh Infection after Prosthetic Patch Repair of Inguinal Hernia

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