Bueno-Lledó José, Torregrosa-Gallud Antonio, Sala-Hernandez Angela, Carbonell-Tatay Fernando, Pastor Providencia G, Diana Santiago B, Hernández José I
Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
Am J Surg. 2017 Jan;213(1):50-57. doi: 10.1016/j.amjsurg.2016.03.007. Epub 2016 Jun 1.
The main objective was to identify predictive factors associated with prosthesis infection and mesh explantation after abdominal wall hernia repair (AWHR).
This is a retrospective review of all patients who underwent AWHR from January 2004 to May 2014 at a tertiary center. Multivariate analysis identified predictors of mesh infection and explantation after AWHR.
From 3,470 cases of AWHR, we reported 66 cases (1.9%) of mesh infection, and 48 repairs (72.7%) required mesh explantation. Steroid or immunosuppressive drugs use (odds ratio [OR] 2.22; confidence interval [CI] 1.16 to 3.95), urgent repair (OR 5.06; CI 2.21 to 8.60), and postoperative surgical site infection (OR 2.9; CI 1.55 to 4.10) were predictive of mesh infection. Predictors of mesh explantation were type of mesh (OR 3.13; CI 1.71 to 5.21), onlay position (OR 3.51; CI 1.23 to 6.12), and associated enterotomy in the same procedure (OR 5.17; CI 2.05 to 7.12).
Immunosuppressive drugs use, urgent repair, and postoperative surgical site infection are predictive of mesh infection. Risk factors of prosthesis explantation are polytetrafluoroethylene mesh, onlay mesh position, and associated enterotomy in the same procedure.
主要目的是确定与腹壁疝修补术(AWHR)后假体感染和补片取出相关的预测因素。
这是一项对2004年1月至2014年5月在一家三级中心接受AWHR的所有患者的回顾性研究。多变量分析确定了AWHR后补片感染和取出的预测因素。
在3470例AWHR病例中,我们报告了66例(1.9%)补片感染,48例修补术(72.7%)需要取出补片。使用类固醇或免疫抑制药物(比值比[OR]2.22;置信区间[CI]1.16至3.95)、急诊修补(OR 5.06;CI 2.21至8.60)和术后手术部位感染(OR 2.9;CI 1.55至4.10)是补片感染的预测因素。补片取出的预测因素包括补片类型(OR 3.13;CI 1.71至5.21)、覆盖位置(OR 3.51;CI 1.23至6.12)以及同一手术中相关的肠切开术(OR 5.17;CI 2.05至7.12)。
使用免疫抑制药物、急诊修补和术后手术部位感染是补片感染的预测因素。假体取出的危险因素包括聚四氟乙烯补片、覆盖补片位置以及同一手术中相关的肠切开术。