ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

Surgical approach of infected mesh with entero-atmospheric fistula – a case presentation

154 views

ABSTRACT

Introduction. Mesh reinforcement is generally considered the standard of care in hernia repair. Infection is a common complication following hernia repair. Infection of the mesh is a complex problem. Knowledge of new treatment strategies is necessary for surgeons performing abdominal wall reconstruction.

Case presentation. We present the case of a 68-year-old woman, who presented with a non-traumatic entero-atmospheric fistula at the site of the hernia repair, which had been done 2 years previously through the implantation of a dual mesh. The fistula has appeared one year previously. The treatment consisted in a complete removal of the infected mesh and segmentary enterectomy. The abdominal wall was repaired through a tissular procedure and the skin was left to close per secundam. The postoperative outcome was favorable.

Conclusions. Following excision of infected mesh, multi-staged abdominal wall reconstruction can be considered. Biologic or biosynthetic mesh is recommended when repairing incisional hernias following excision of infected mesh and likely represent the patient’s best chance for a definitive hernia repair. Negative pressure wound therapy closure should be considered in higher-risk patients. Mesh infection is a complex complication that is commonly encountered by surgeons performing hernia repair. Prevention through patient optimization should be performed whenever appropriate. However, when patients develop a mesh infection, most of them will require a complete mesh excision and recurrent hernia repair.

Keywords: mesh, infection, abdominal, hernia, repair.

Full text sources https://doi.org/10.31688/ABMU.2019.54.3.29 How to cite Email to Author Format XML


Correspondence address:
Bogdan SOCEA
Emergency Clinical Hospital “Sf. Pantelimon” General Surgery Clinic
Address: Soseaua Pantelimon no. 340-342, 1st floor, General Surgery Department
Email bogdansocea@gmail.com;Phone: +40788491091; Fax: +40212550064

Share.

Comments are closed.

Mihalache DI, Socea B, Smaranda AC, Nica AA, Carap AC, Bratu OG, Stanescu AMA, Groseanu F, Dimitriu MCT, Constantin VD. Surgical approach of infected mesh with entero-atmospheric fistula - a case presentation. Arch Balk Med Union. 2019;54(3):591-595.