Early and Late Outcome After Suprasonic Excision of Infected Mesh Implants After Hernioplasty

Abstract

Th e purpose of this research is to analyze early and postponed complications of the new method to eliminate mesh implants during full-grown infection process.Th e Republican clinical hospital (Russia) was the location to carry out a post-hoc analysis of 149 cases on surgical removal of infected mesh implants for ventral hernias of different localization in the period 2000 to 2017. Th e control group were 78 patients who underwent meshes removal with traditional surgical instruments. Th e study group included 71 patients, who underwent our method of supra-sonic excision of the implants.Th e duration of surgery in the group of patients subjected to supra-sonic excision of the implants was signifi cantly lower (84.3 min vs. 141.5 min) than in the group of traditional surgical techniques. Complications of early postoperative period was most often registered in the control group: foreign bodies (92.8% vs. 7.2%), infection (81.8% vs. 18.2%) and bleeding (87.5% vs. 12.5%). In the long term the recurrence of hernias in the control group were detected 1.8 times more frequently for ventral hernias than in the group of supra-sonic excision of the implants.Th us, supra-sonic excision of the implant prevents damage to viable tissues of the abdominal wall during the allocation of the implant and provides a good bactericidal eff ect, which promotes normal tissue regeneration and prevents possible recurrence of the herniation. Keywords: hernias, suprasonic excision of infected mesh, early and late outcome SAŽETAKCilj ovog istraživanja je analiza ranih i odloženih komplikacija novog metoda za eliminaciju mrežnih impantata tokom celokupnog procesa infekcije.Republička klinička bolnica (Rusija) je predstavljala lokaciju sprovođenje post-hoc analize 149 slučajeva hirurškog uklanjanja infi ciranih mrežnih impantata ventralnih kila različite lokalizacije u periodu od 2000. do 2017. Kontrolnu grupu je činilo 78 pacijenata kod kojih je mrežica uklonjena tradicionalnim hirurškim instrumenti. Eksperimentalna grupa se sastojala od 71 pacijenta koji su bili podvrgnuti našem metodu suprazvučne ekscizije impantata.Trajanje hirurške intervencije u grupi pacijenata podvrgnutih suprazvučnoj eksciziji implantata značajno je bila niža (84,3 min naspram 141,5 min) nego u grupi u kojoj su korišćene tradicionalne hirurške tehnike. Komplikacije ranog postoperativnog perioda su najčešć e registrovane u kontrolnoj grupi: strana tela (92,8% naspram 7,2%), infekcija (81,8% naspram 18,2%) i krvarenje (87,5% naspram 12,5%). U pogledu kasnih ishoda ponovna pojava kila u kontrolnoj grupi je zabeležena 1.8 puta češć e nego u grupi sa suprazvučnom ekscizijom implantata.Prema tome, suprazvučna ekscizija implantata prevenira ošteć enja tkiva abdominalnog zida prilikom ugradnje implantata i pruža dobar baktericidni efekat, što stimuliše normalnu regeneraciju tkiva i sprečava moguć unost ponovne pojave kila.Ključne reči: kila, suprazvučna ekscizija infi cirane mreže, rani i kasni ishodi

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