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СLINICAL CASE OF TREATMENT OF A PATIENT WITH POSTOPERATIVE VENTRAL HERNIA AND COMPLICATION DURING THE POSTOPERATIVE PERIOD IN THE FORM OF MESH PROSTHESIS INFECTION

https://doi.org/10.17238/issn2072-3180.2020.4.101-111

Abstract

Introduction: more than 20 million hernia surgeries are performed worldwide each year. Abdominal hernias are detected in 7% of the total population, mainly in people of working age. Hernia of the anterior abdominal wall is one of the most common surgical problems affecting a significant proportion of patients around the world. The main causes of hernias are a violation of the level collagen ratio in the scar tissue and technical errors in the technique of closing laparotomic wounds, which leads to the formation of postoperative hernias.
Clinical case: the article presents a clinical case of treatment of a patient with postoperative ventral hernia and «domain loss», complicated by infection of the mesh prosthesis in the postoperative period. Difficulties in choosing the optimal treatment tactics for this category of patients, such as making a decision to remove the mesh prosthesis or to continue conservative methods of treatment, have been noted.
Conclusion: conservative methods inevitably increase the duration of treatment and hospital stay, which adversely affects not only the physical condition of the patient, but also the psychological element of long-term therapy. The chosen strategy in this clinical case was compared with previously published materials of other authors. Treatment of this category of patients should be carried out in hospitals of a wide profile, which have in their arsenal all the necessary diagnostic equipment, the possibility of operative consultation of any related specialist, if necessary, as well as the possibility of timely change of antibacterial drugs, if required by the clinical situation.

About the Authors

A. A. Kovalev
Almazov National Medical Research Centre
Russian Federation

Kovalev Aleksandr Andreevich — surgeon of the Department of surgical methods of treatment of cancer patients

2 Akkuratov street, 197341 St. Petersburg



I. N. Danilov
Almazov National Medical Research Centre
Russian Federation

Danilov Ivan Nikolaevich — PhD in Meddicine, Head of the Department of surgical methods of treatment of cancer patients

2 Akkuratov street, 197341 St. Petersburg



D. B. Nasedkin
Almazov National Medical Research Centre
Russian Federation

Nasedkin Dmitrii Borisovitch — surgeon of the Department of surgical methods of treatment of cancer patients

2 Akkuratov street, 197341 St. Petersburg



M. A. Salov
Almazov National Medical Research Centre
Russian Federation

Salov Maksim Alekseevich — surgeon of the Department of surgical methods of treatment of cancer patients

2 Akkuratov street, 197341 St. Petersburg



I. Yu. Kasherininov
Almazov National Medical Research Centre
Russian Federation

Kasherininov Igor Yur’evich — PhD in Medicine, Head of the Intensive care unit №4

2 Akkuratov street, 197341 St. Petersburg



A. E. Neimark
Almazov National Medical Research Centre
Russian Federation

Neimark Aleksandr Evgen’evich — MD, PhD. eLibrary SPIN: 6554-3217

2 Akkuratov street, 197341 St. Petersburg



I. V. Basek
Almazov National Medical Research Centre
Russian Federation

Basek Ilona Vladimirovna — PhD in Medicine, Docent, Head of the Department of Radiolody

2 Akkuratov street, 197341 St. Petersburg



References

1. 1. Kirienko A.I., Shevtsov Y.N., Nikishkov A.S., Seliverstov E.I., Andriyashkin A.V., Tatarintsev A.M., Zolotuhin I.A. Rasprostranennost’ gryzh perednei bryushnoi stenki: rezul’taty populyatsionnogo issledovaniya [Incidence of abdominal wall hernias: the results of population study]. Khirurgiia, 2016, (8), pp. 61–66. https://doi.org/10.17116/hirurgia2016861-66 (In Russ.)

2. Chistjakov D.B., Movchan K.N., Rusakevich K.I., Jakovenko T.V., Sen’kov R.Je. Osnovnye statisticheskie parametry okazanija medicinskoj pomoshhi zhiteljam Sankt-Peterburga pri gryzhah zhivota v formate objazatel’nogo medicinskogo strahovanija. [Introduction: the main statistical parameters of providing medical care to residents of St. Petersburg for abdominal hernias in the format of compulsory medical insurance]. Sovremennye problemy nauki i obrazovanija, 2016, 5, p. 97–97. (In Russ.)

3. Grant A.M., EU Hernia Trialists Collaboration. Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data [corrected]. Hernia: the journal of hernias and abdominal wall surgery, 2002, No. 6(3), pp/ 130–136. https://doi.org/10.1007/s10029-002-0073-1

4. Gillion J.F., Palot J.P. Abdominal wall incisional hernias: infected prosthesis: treatment and prevention. Journal of visceral surgery, 2012, No. 149(5), pp. 20–31. https://doi.org/10.1016/j.jviscsurg.2012.04.003

5. Shankar V.G., Srinivasan K., Sistla S.C., Jagdish S. Prophylactic antibiotics in open mesh repair of inguinal hernia - a randomized controlled trial. International journal of surgery (London, England), 2010, No. 8(6), pp. 444–447. https://doi.org/10.1016/j.ijsu.2010.05.011

6. Edwards C., Angstadt J., Whipple O., Grau R. Laparoscopic ventral hernia repair: postoperative antibiotics decrease incidence of seroma-related cellulitis. The American surgeon, 2005, No. 71(11), pp. 931–936.

7. Brown R.H., Subramanian A., Hwang C.S., Chang S., Awad S.S. Comparison of infectious complications with synthetic mesh in ventral hernia repair. American journal of surgery, 2013, No. 205(2), pp. 182–187. https://doi.org/10.1016/j.amjsurg.2012.02.023

8. Sharma R., Fadaee N., Zarrinkhoo E., Towfigh S. Why we remove mesh. Hernia: the journal of hernias and abdominal wall surgery, 2018, No. 22(6), pp. 953–959. https://doi.org/10.1007/s10029-018-1839-4

9. Stremitzer S., Bachleitner-Hofmann T., Gradl B., Gruenbeck M., Bachleitner-Hofmann B., Mittlboeck M., Bergmann M. Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations. World journal of surgery, 2010, No. 34(7), pp. 1702–1709. https://doi.org/10.1007/s00268-010-0543-z

10. Erdas E., Medas F., Pisano G., Nicolosi A., Calò P.G. Antibiotic prophylaxis for open mesh repair of groin hernia: systematic review and metaanalysis, Hernia, 2016, No. 20(6), pp. 765–776. https://doi.org/10.1007/s10029-016-1536-0

11. Bueno-Lledó J., Torregrosa-Gallud A., Sala-Hernandez A., Carbonell-Tatay F., Pastor P. G., Diana S. B., Hernández J. I. Predictors of mesh infection and explantation after abdominal wall hernia repair. American journal of surgery, 2017, No. 213(1), pp. 50–57. https://doi.org/10.1016/j.amjsurg.2016.03.007

12. Mavros M.N., Athanasiou S., Alexiou V.G. et al. Risk Factors for Mesh-related Infections After Hernia Repair Surgery: A Meta-analysis of Cohort Studies. World J. Surg., 2011, 13. No. 35, p. 2389. https://doi.org/10.1007/s00268-011-1266-5

13. Díaz-Godoy A., García-Ureña M.Á., López-Monclús J. et al. Searching for the best polypropylene mesh to be used in bowel contamination. Hernia, 2011, No. 15, pp. 173–179. https://doi.org/10.1007/s10029010-0762-0

14. Prieto-Borja L., Pérez-Tanoira R., Levano-Linares D.C., Celdrán A., Mahillo-Fernández I., Esteban J. Sonication of Abdominal Drains: Clinical Implications of Quantitative Cultures for the Diagnosis of Surgical Site Infection. Surgical infections, 2016, No. 17(4), pp. 459–464. https://doi.org/10.1089/sur.2015.268

15. Kao A.M., Arnold M.R., Augenstein V.A., Heniford B.T. Prevention and Treatment Strategies for Mesh Infection in Abdominal Wall Reconstruction. Plastic and reconstructive surgery, 2018, No. 142(3), pp.149–155. https://doi.org/10.1097/PRS.0000000000004871

16. Guillaume O., Pérez-Tanoira R., Fortelny R., Redl H., Moriarty T.F., Richards R.G., Eglin D., Petter Puchner A. Infections associated with mesh repairs of abdominal wall hernias: Are antimicrobial biomaterials the longed-for solution? Biomaterials, 2018, No. 167, pp. 15–31. https://doi.org/10.1016/j.biomaterials.2018.03.017

17. Alston D., Parnell S., Hoonjan B., Sebastian A., Howard A. Conservative management of an infected laparoscopic hernia mesh: A case study, International Journal of Surgery Case Reports, 2013, 4(11), pp. 1035–1037. https://doi.org/10.1016/j.ijscr.2013.08.008

18. Trunzo J.A., Ponsky J.L., Jin J., Williams C.P., Rosen M.J. A novel approach for salvaging infected prosthetic mesh after ventral hernia repair. Hernia: the journal of hernias and abdominal wall surgery, 2009, 13(5), pp. 545–549. https://doi.org/10.1007/s10029-009-0470-9

19. Meagher H., Clarke Moloney M., Grace P.A. Conservative management of mesh-site infection in hernia repair surgery: a case series. Hernia: the journal of hernias and abdominal wall surgery, 2015, 2, pp. 231–237. https://doi.org/10.1007/s10029-013-1069-8

20. Kingsnorth A.N., Sivarajasingham N., Wong S., Butler M. Open mesh repair of incisional hernias with significant loss of domain. Annals of the Royal College of Surgeons of England, 2004, 86(5), pp. 363–366. https://doi.org/10.1308/147870804236

21. Mcadory R.S., Cobb W.S., Carbonell A.M. Progressive preoperative pneumoperitoneum for hernias with loss of domain. The American surgeon, 2009, 75(6), pp. 504–509.

22. Bueno-Lledó J., Carreño-Saenz O., Torregrosa-Gallud A., PousSerrano S. Preoperative Botulinum Toxin and Progressive Pneumoperitoneum in Loss of Domain Hernias-Our First 100 Cases. Frontiers in surgery, 2020, 7, рр. 3. https://doi.org/10.3389/fsurg.2020.00003

23. Tang F.X., Zong Z., Xu J.B., Ma N., Zhou T.C., Chen S. Combination of Preoperative Progressive Pneumoperitoneum and Botulinum Toxin A Enables the Laparoscopic Transabdominal Preperitoneal Approach for Repairing Giant Inguinoscrotal Hernias. Journal of laparoendoscopic & advanced surgical techniques. 2020, A, 30(3), pp. 260–266. https://doi.org/10.1089/lap.2019.0669

24. Mancini A., Mougin N., Venchiarutti V., Shen Z., Risse O., Abba J., Arvieux C Goni Moreno progressive preoperative pneumoperitoneum for giant hernias: a monocentric retrospective study of 162 patients. Hernia: the journal of hernias and abdominal wall surgery, 2020, 24(3), pp. 545–550. https://doi.org/10.1007/s10029-019-02113-5

25. Bueno-Lledó J., Torregrosa A., Jiménez R., Pastor P.G. Preoperative combination of progressive pneumoperitoneum and botulinum toxin type A in patients with loss of domain hernia. Surgical endoscopy, 2018, 32(8), pp. 3599–3608. https://doi.org/10.1007/s00464-018-6089-0

26. Gonzalez-Urquijo M., Estrada-Cortinas O.J., Rodarte-Shade M., Bermea-Mendoza J.H., Gil-Galindo G. Preoperative progressive pneumoperitoneum: The answer for treating giant inguinal hernias while avoiding morbidities? Hernia: the journal of hernias and abdominal wall surgery, 2020, 24(4), pp. 781–786. https://doi.org/10.1007/s10029-020-02155-0


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For citations:


Kovalev A.A., Danilov I.N., Nasedkin D.B., Salov M.A., Kasherininov I.Yu., Neimark A.E., Basek I.V. СLINICAL CASE OF TREATMENT OF A PATIENT WITH POSTOPERATIVE VENTRAL HERNIA AND COMPLICATION DURING THE POSTOPERATIVE PERIOD IN THE FORM OF MESH PROSTHESIS INFECTION. Moscow Surgical Journal. 2020;(4):101-111. (In Russ.) https://doi.org/10.17238/issn2072-3180.2020.4.101-111

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ISSN 2072-3180 (Print)