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疝修补补片感染的保守治疗

[Conservative management of hernia mesh infection].

作者信息

Ruiz-Tovar Jaime, Rey Ibarra Antonio, Devesa Múgica José Manuel

机构信息

Servicio de Cirugía General y Digestiva, Hospital General Universitario de Elche, Alicante, España.

出版信息

Rev Gastroenterol Peru. 2011 Oct-Dec;31(4):386-8.

Abstract

INTRODUCTION

Standard management of infected mesh advocates its removal, but this often results in a larger hernia than at the time of original repair. In this article we describe a novel approach to manage conservatively an infected prosthetic mesh.

PATIENT AND METHODS

Mesh infection rate at our institution was 1%. We describe 3 cases (inguinal, ventral and parastomal hernias) that presented prosthetic mesh infections. All the cases were satisfactorily managed with a conservative approach, consisting in wound opening and pressurized wound irrigation with gentamicin (80mg/8hours) and intravenous infusion of Amoxicilin/Clavulanic acid (875mg+125mg/8hours) during 7 days, achieving sterile cultures of the mesh surface in all the cases. A 3rd intention closure of the wound was performed. There is no clinical evidence of recurrent infection in any case.

CONCLUSION

Conservative management of mesh infection, including drainage, antibiotic irrigation and wound closure, is a potential alternative to mesh removal.

摘要

引言

感染补片的标准处理方法是将其移除,但这往往会导致疝比初次修补时更大。在本文中,我们描述了一种保守处理感染人工补片的新方法。

患者与方法

我们机构的补片感染率为1%。我们描述了3例(腹股沟疝、腹壁疝和造口旁疝)出现人工补片感染的病例。所有病例均采用保守方法成功处理,包括伤口开放、用庆大霉素(80mg/8小时)进行加压伤口冲洗以及静脉输注阿莫西林/克拉维酸(875mg + 125mg/8小时),持续7天,所有病例补片表面培养均无菌。伤口进行了三期缝合。所有病例均无复发性感染的临床证据。

结论

补片感染的保守处理,包括引流、抗生素冲洗和伤口闭合,是补片移除的一种潜在替代方法。

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