Necrotising fasciitis following inguinal hernia repair

Turner, Emma; Owen, E. R. T. C.; Reddy, Kaunteya

doi:10.1136/bcr.01.2009.1535

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Although this cannot be generalized to other types of meshes, still it is worth identifying the causes for it and ways to prevent it. It is difficult to say where the infection came from and whether it was endogenous or exogenous [2]. Colonization of bacteria, properties of mesh, methods of sterilization and disinfection of laparoscopic instruments and mycobacterial infection constitute important aspects regarding mesh infection.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Mesh Infection—Still a Concern in Laparoscopic Era

et al. 2015

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Introduction of synthetic mesh was a landmark breakthrough in the management of hernia repair and has significantly reduced recurrence rates. But in addition to the benefits, some more problems have come in picture major being 'mesh infection'. Prolene mesh has shown promise when used in abdominal and inguinal hernia repair, especially when used in planned surgeries. This material, derived from monofilament polypropelene, is found to be biologically inert in almost every person. Being a foreign material, a slightest breach in asepsis can lead to favourable environment for bacterial proliferation and form a 'biofilm'. This phenomenon especially after laparoscopic surgeries gives rise to chronic discharging sinus at the port site, abscess formation around mesh and even sepsis. It appears that laparoscopic hernia repair is a promising method but having chances of mesh infection owing to difficult approach and lack of uniformity in sterilization of laparoscopic instruments. Slightest breach in sterility or protocols might lead to such a large ventral wall sinus, increasing morbidity and cost of treatment. Treatment of infected mesh is possible by local debridement, irrigation, mesh removal and systemic antibiotics culminating in increased morbidity over duration of disease, but still it would be worth emphasizing-'Prevention is better than cure'.

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Section: Introductionmentioning

confidence: 99%

Postoperative Mesh Infection—Still a Concern in Laparoscopic Era

et al. 2015

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“…[24,25] Necrotising fasciitis like serious life-threatening infections are reported in the literature after mesh insertion. [26] Smoking is associated with connective tissue disruption, thereby increasing the incidence of recurrence. [27] We have done mesh repair as per the earlier criteria only.…”

Section: Managementmentioning

confidence: 99%

Retrospective Descriptive Study of Abdominal Wall Hernias and Their Management

Sambasivudu¹,

Vineela²,

Ramana³

2018

jemds

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BACKGROUND This is a retrospective descriptive study of 422 cases of abdominal wall hernias done by single surgeon and their follow-up upto 12 years. Abdominal wall hernias are a group of conditions, which occur mainly through the natural openings and weak areas of abdominal wall-1. Groin, 2. Ventral part of the anterior abdominal wall, 3. Previous operative sites and 4. Through natural openings and weak areas of abdominal wall. MATERIALS AND METHODS 422 cases of abdominal wall hernias treated in the last 12 years along with their management were studied. They were followed upto 12 yrs. The differences in the selection of cases and surgical skill are excluded in the study by including cases done by single surgeon (1 st Author) only. Only open surgeries are included in the study to avoid learning curve mistakes. Mode of Presentation-Elective and emergency surgery and their management is discussed. Anatomical tissue repair, monofilament polypropylene mesh repair in primary and recurrent hernias of various varieties and their results were studied. Bowel resections, omental excisions and separation of bowel adhesions (Adhesiolysis) in sliding and irreducible hernias are analysed. Various complications including mortality are discussed. RESULTS No recurrences were observed in mesh hernioplasty patients. 6 cases of recurrences were observed in anatomical repair patients-1.4%. Monofilament polypropylene mesh was used and fixed to the tissues with 2.0 prolene. 3 patients expired in our series in complicated and strangulated cases-0.7%. CONCLUSION Prolene mesh repair is definitely superior to anatomical tissue repairs in all cases of abdominal wall hernias. Anatomical tissue repair in young good musculature and small defects gives equally good results in experienced hands.

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“…It is not easy to detect whether the source of the infection is endogenous or exogenous [2]. Literature suggests that 10% of infections are seen after the use of polytetrafluoroethylene (PTFE) mesh for the repair of hernia [3]. Other factors responsible for mesh infections are mycobacterial infection, sterilization methods, and methods of disinfection of laparoscopic instruments.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Mesh Infection in Patient with Laparoscopic Inguinal Hernia Repair: A Retrospective Study

.¹,

Afzal²,

Bazai³

et al. 2021

PJMHS

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Aim: To evaluate Post-Laparoscopic infection in Mesh followed by inguinal hernia repair. Study design: A retrospective study Place and Duration: This study was conducted at Jinnah Postgraduate and Medical Centre Karachi from April 2021 to April 2022 Methodology: A total of 80 participants were included in the study. All the patients had an extensive infection in the mesh followed by mesh hernia repair through laparoscopy. The preoperative workup was done for all the patients before a laparoscopic excision of mesh. A drain was placed in the preperitoneal space after the removal of the mesh. Closure of the peritoneal flap was done after that with a 3/0 absorbable suture. Result: The course of the operation was uneventful for all the patients. Only two patients required a sigmoidectomy for the repair of the fistula. Three patients presented with contralateral side infection and mesh residues around the pubic. A second laparoscopy was done on those three patients. Recurrence of hernia was seen in four of the cases observed on follow-up. Conclusion: Laparoscopic removal of the mesh is a superior approach to the open surgical removal of the mesh for the treatment of mesh infection. However, prevention of infection by prophylactic antibiotics, maintaining an aseptic environment during hernia repair surgery, and proper sterilization of the instruments can prevent the infection. Keywords: laparoscopic, mesh infection, inguinal hernia repair

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Necrotising fasciitis following inguinal hernia repair

Abstract: We report a case of necrotising fasciitis following inguinal hernia repair. It is rare for clean operations such as hernia repair to be associated with infection, and even rarer for them to be associated with necrotising fasciitis, with only a few reports in the literature.

Cited by 3 publications

References 6 publications

Postoperative Mesh Infection—Still a Concern in Laparoscopic Era

Postoperative Mesh Infection—Still a Concern in Laparoscopic Era

Retrospective Descriptive Study of Abdominal Wall Hernias and Their Management

Evaluation of Mesh Infection in Patient with Laparoscopic Inguinal Hernia Repair: A Retrospective Study

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