Kercher Kent W, Sing Ronald F, Matthews Brent D, Heniford B Todd
Department of Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA.
Ostomy Wound Manage. 2002 Oct;48(10):40-2, 44-5.
Rates of hernia recurrence following repair of abdominal wall hernia defects have been shown to be lower when prosthetic biomaterials are used, but their presence may be associated with a higher rate of infectious complications. Traditional surgical teaching has advocated removal of contaminated or exposed prosthetics, although the morbidity of these revisions is high. The case presented involves a ventral hernia repair complicated by methicillin-resistant Staphylococcus aureus infection and exposed polytetrafluoroethylene mesh. The open abdominal wound was successfully managed with a combination of intravenous antibiotics, local wound debridement, vacuum-assisted closure, and soft tissue coverage of the mesh. Eighteen months following surgical closure of the wound, no hernia recurrence or infection was evident.
腹壁疝缺损修复术后使用人工生物材料时,疝复发率已被证明较低,但其存在可能与感染并发症发生率较高有关。传统外科教学主张去除受污染或暴露的假体,尽管这些翻修手术的发病率很高。本文介绍的病例是一例腹疝修补术,并发耐甲氧西林金黄色葡萄球菌感染和聚四氟乙烯网片暴露。通过静脉注射抗生素、局部伤口清创、负压封闭引流以及网片的软组织覆盖相结合的方法,成功处理了开放性腹部伤口。伤口手术闭合18个月后,未发现疝复发或感染迹象。