title: Successful salvage of infected PTFE mesh after ventral hernia repair.
abstract: Rates of hernia recurrence following repair of abdominal wall hernia defects have been shown to be lower when prosthetic biomaterials are used, but their presence may be associated with a higher rate of infectious complications. Traditional surgical teaching has advocated removal of contaminated or exposed prosthetics, although the morbidity of these revisions is high. The case presented involves a ventral hernia repair complicated by methicillin-resistant Staphylococcus aureus infection and exposed polytetrafluoroethylene mesh. The open abdominal wound was successfully managed with a combination of intravenous antibiotics, local wound debridement, vacuum-assisted closure, and soft tissue coverage of the mesh. Eighteen months following surgical closure of the wound, no hernia recurrence or infection was evident.
authors.affiliation: Department of Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA. kkercher@carolinas.org
authors.forename: Kent W
authors.initials: KW
authors.lastname: Kercher
authors.forename: Ronald F
authors.initials: RF
authors.lastname: Sing
authors.forename: Brent D
authors.initials: BD
authors.lastname: Matthews
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D016106:Methicillin Resistance; D009767:Obesity, Morbid / Q000150:complications; D011138:Polytetrafluoroethylene; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D017592:Skin Care / Q000379:methods; D013203:Staphylococcal Infections / Q000209:etiology* / Q000517:prevention & control*; D013211:Staphylococcus aureus; D013396:Suction / Q000379:methods; D013526:Surgical Mesh / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000209:etiology* / Q000517:prevention & control*; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D011138:Polytetrafluoroethylene