Ozaki Kana, Tanimura Kenji, Ebina Yasuhiko, Kanemitsu Kiyonori, Yamada Hideto
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
J Med Case Rep. 2017 Mar 11;11(1):66. doi: 10.1186/s13256-017-1217-3.
Surgical meshes are widely used in incisional hernia repair. However, there are no reports of pregnancies complicated by infection of surgical meshes used for hernia repair. This is the first case report of a pregnant woman who experienced surgical site infection associated with surgical mesh used for repair of an abdominal wall incisional hernia.
We report a case of a 41-year-old pregnant Japanese woman with surgical site infection after mesh repair of an abdominal wall incisional hernia. She was diagnosed with an abdominal wall incisional hernia at 3 months after her third cesarean section, and she underwent an operation of hernia repair with use of monofilament polypropylene mesh 7 months after the third cesarean section. However, a surgical site infection associated with surgical mesh occurred. During antibiotic treatment, she was found to be pregnant. She was referred to our hospital at 13 weeks and 2 days of gestation. The surgeons removed the infected mesh at 16 weeks and 3 days of gestation. Neither the hernia nor infection at the surgical site recurred throughout pregnancy. We planned a cesarean section using a transverse uterine fundal incision method with an upper abdominal incision. The patient delivered a 2478-g healthy female infant.
The present report shows that removal of mesh can safely control surgical site infection during pregnancy.
外科补片广泛应用于切口疝修补术。然而，尚无关于妊娠合并用于疝修补的外科补片感染的报道。本文首次报道了一名孕妇因用于腹壁切口疝修补的外科补片发生手术部位感染的病例。
我们报告了一例41岁的日本孕妇，她在腹壁切口疝补片修补术后发生手术部位感染。她在第三次剖宫产术后3个月被诊断为腹壁切口疝，并在第三次剖宫产术后7个月接受了使用单丝聚丙烯补片的疝修补手术。然而，发生了与外科补片相关的手术部位感染。在抗生素治疗期间，发现她怀孕了。她在妊娠13周零2天时被转诊至我院。外科医生在妊娠16周零3天时取出了感染的补片。整个孕期疝和手术部位感染均未复发。我们计划采用子宫底部横切口加腹部上切口的方法进行剖宫产。患者分娩出一名体重2478克的健康女婴。
本报告表明，在妊娠期取出补片可安全控制手术部位感染。
