Comment on: Conservative management of an infected laparoscopic hernia mesh: A case study.
BACKGROUND
We recently published an article in this journal describing the successful conservative treatment of a patient with an infected laparoscopically inserted hernia mesh using gentamycin flushes via a pig-tail drain and long term oral antibiotics. This prevented the need for major reconstructive surgery. However, 3 months after we published our report, the patient re-presented with symptoms of a recurrence of infection.


METHODS
Seven months after stopping oral antibiotics, our patient represented with fever and swelling and redness over his left sided inguinal hernia mesh. This mesh had to be surgically removed. The procedure was laparoscopic and showed infection confined to the central 5cm of the mesh. Microbiology culture results were the same as on initial presentation.


CONCLUSIONS
The microbiology results suggest that it is likely that the infection was never fully eradicated and that our intervention merely kept the infection at bay. Once long term antibiotics were stopped it is likely that the infection was able to eventually recur.


CONCLUSIONS
Consequently, we have been unable to show that our method of conservative management of infected hernia meshes is effective to prevent long term recurrence of infection.
Department of Vascular Surgery, Colchester General Hospital, Turner Road, Colchester CO4 5JL, United Kingdom. Electronic address: dsalston@gmail.com.
Duncan
D
Alston
Department of Vascular Surgery, Colchester General Hospital, Turner Road, Colchester CO4 5JL, United Kingdom.
Stephanie
S
Parnell
Department of Vascular Surgery, Colchester General Hospital, Turner Road, Colchester CO4 5JL, United Kingdom.
Bhupinder
B
Hoonjan
Department of Vascular Surgery, Colchester General Hospital, Turner Road, Colchester CO4 5JL, United Kingdom.
Arun
A
Sebastian
Department of Vascular Surgery, Colchester General Hospital, Turner Road, Colchester CO4 5JL, United Kingdom.
Adam
A
Howard