Tamura Tetsuro, Ohata Yoshihiro, Katsumoto Fujio
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery, JR Kyushu Hospital, Moji, Kitakyushu, Japan.
Surg Case Rep. 2019 Sep 5;5(1):140. doi: 10.1186/s40792-019-0697-3.
Very few literatures can be found reporting cases and treatment strategies of late-onset mesh infection after abdominal incisional hernia reconstruction. Here, we report a rare case of delayed mesh infection developed 10 years after abdominal incisional hernia repair, which was successfully treated by mesh removal and reconstruction with posterior components separation technique.
A 66-year-old man, who underwent reconstruction of abdominal incisional hernia by retroperitoneal Composix mesh application 10 years prior, developed 12 × 6.0 × 2.5 cm subcutaneous abscess followed by methicillin-resistant Staphylococcus aureus (MRSA)-related mesh infection. The operation was performed excising the abscess wall without damaging peritoneum, and huge intermuscular defect was successfully reconstructed by posterior components separation technique application.
An early decision of excising contaminated mesh would be preferable to extensive conservative treatments when mesh infection is suspected. Components separation technique application can be of great help when designing reconstruction of huge intramuscular defect after removal of infected mesh.
关于腹部切口疝修补术后迟发性补片感染的病例及治疗策略的报道极少。在此，我们报告一例罕见的腹部切口疝修补术后10年发生的迟发性补片感染病例，通过移除补片并采用后入路腹壁分层分离技术进行重建成功治愈。
一名66岁男性，10年前曾应用腹膜后Composix补片进行腹部切口疝修补，现出现一个12×6.0×2.5 cm的皮下脓肿，随后发生耐甲氧西林金黄色葡萄球菌（MRSA）相关的补片感染。手术切除脓肿壁且未损伤腹膜，通过应用后入路腹壁分层分离技术成功重建了巨大的肌间缺损。
当怀疑补片感染时，早期决定切除受污染的补片比广泛的保守治疗更可取。在设计感染补片移除后巨大肌内缺损的重建时，应用腹壁分层分离技术会有很大帮助。
