Successful salvage of infected PTFE mesh after ventral hernia repair.
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.
Kercher
Kent W
KW
Department of Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA. kkercher@carolinas.org
Sing
Ronald F
RF
Matthews
Brent D
BD
Heniford
B Todd
BT
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
D000900:Anti-Bacterial Agents; D011138:Polytetrafluoroethylene