目的:网状物感染是无菌疝修补术的一种严重并发症。本研究旨在评估腹股沟疝修补术后网片感染治疗后的短期和长期结果。
方法:这项单中心回顾性研究包括2018年1月至2020年12月腹股沟疝修补术后发生网片感染的所有患者。患者人口统计学,网状感染特征,微生物学,手术的特点,短期和长期结果,并对随访数据进行分析。
结果:总计,120名患者(8名女性,112名男性;平均年龄,54.4年;平均体重指数,24.8kg/m2)处理网片感染。88例患者的培养为阳性;其中62.5%的金黄色葡萄球菌阳性。对108例患者进行了腹腔镜探查。70例患者接受了感染网片的完全切除,50人接受了部分切除。在短期随访期间,11例患者出现了轻微的伤口感染,并接受了敷料和抗生素治疗,1出现了需要清创的伤口感染,30个发达的血清,3例出现不需要手术治疗的血肿.平均随访39.1个月,4例患者出现疝气复发,2经历慢性疼痛,23例发生复发性感染,需要在部分网片切除组中再次手术(相比之下,完全去除网片组只有4例患者出现反复感染,具有统计学上的显著差异)。
结论:腹股沟疝修补术后网片感染的疗效满意。由经验丰富的专家根据患者以前的修复技术进行系统的个性化治疗,植入网,和身体状况建议。
Mesh infection is a devastating complication of sterile hernia repair surgery. This study was performed to assess the short- and long-term outcomes following treatment for mesh infection after inguinal hernia repair.
This single-center retrospective study included all patients who developed mesh infection after inguinal hernia repair from January 2018 to December 2020. Patient demographics, mesh infection characteristics, microbiology, features of surgery, short- and long-term outcomes, and follow-up data were analyzed.
In total, 120 patients (8 women, 112 men; mean age, 54.4 years; mean body mass index, 24.8 kg/m2) were treated for mesh infection. The cultures were positive in 88 patients; 62.5% of these were positive for Staphylococcus aureus. Laparoscopic exploration was performed in 108 patients. Seventy patients underwent complete removal of infected mesh, and 50 underwent partial removal. During the short-term follow-up, 11 patients developed a minor wound infection and were treated with dressings and antibiotics, 1 developed a wound infection requiring debridement, 30 developed seromas, and 3 developed hematomas that did not require surgical intervention. During the mean follow-up of 39.1 months, 4 patients developed hernia recurrence, 2 experienced chronic pain, and 23 developed recurrent infection requiring reoperation in the partial mesh removal group (in contrast, only 4 patients in the complete mesh removal group developed recurrent infection, with a statistically significant difference).
The outcome of mesh infection after inguinal hernia repair treated by mesh removal is satisfactory. Systematic individualized treatment by experienced experts based on the patient\'s previous repair technique, implanted mesh, and physical condition is recommended.