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Tytuł pozycji:

Biosynthetic Resorbable Prosthesis is Useful in Single-Stage Management of Chronic Mesh Infection After Abdominal Wall Hernia Repair.

Tytuł:
Biosynthetic Resorbable Prosthesis is Useful in Single-Stage Management of Chronic Mesh Infection After Abdominal Wall Hernia Repair.
Autorzy:
Bueno-Lledó J; Unit of Abdominal Wall Surgery, Department of Digestive Surgery, Hospital Universitari I Politecnic 'La Fe', University of Valencia, Calle Gabriel Miró 28, puerta 12, 46008, Valencia, Spain. .
Ceno M; Klinikum Mittelbaden, Balger Strasse 50, 76530, Baden-Baden, Germany.
Perez-Alonso C; Unit of Abdominal Wall Surgery, Department of Digestive Surgery, Hospital Universitari I Politecnic 'La Fe', University of Valencia, Calle Gabriel Miró 28, puerta 12, 46008, Valencia, Spain.
Martinez-Hoed J; Unit of Abdominal Wall Surgery, Department of Digestive Surgery, Hospital Universitari I Politecnic 'La Fe', University of Valencia, Calle Gabriel Miró 28, puerta 12, 46008, Valencia, Spain.
Torregrosa-Gallud A; Unit of Abdominal Wall Surgery, Department of Digestive Surgery, Hospital Universitari I Politecnic 'La Fe', University of Valencia, Calle Gabriel Miró 28, puerta 12, 46008, Valencia, Spain.
Pous-Serrano S; Unit of Abdominal Wall Surgery, Department of Digestive Surgery, Hospital Universitari I Politecnic 'La Fe', University of Valencia, Calle Gabriel Miró 28, puerta 12, 46008, Valencia, Spain.
Źródło:
World journal of surgery [World J Surg] 2021 Feb; Vol. 45 (2), pp. 443-450. Date of Electronic Publication: 2020 Oct 06.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: New York, Springer International.
MeSH Terms:
Absorbable Implants*
Hernia, Abdominal/*surgery
Herniorrhaphy/*adverse effects
Prosthesis-Related Infections/*surgery
Surgical Mesh/*adverse effects
Abdominal Wall/surgery ; Adult ; Aged ; Chronic Disease ; Device Removal ; Female ; Hernia, Ventral/surgery ; Herniorrhaphy/methods ; Humans ; Male ; Middle Aged ; Polymers ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/microbiology ; Recurrence ; Retrospective Studies ; Surgical Mesh/microbiology ; Treatment Outcome
References:
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Substance Nomenclature:
0 (Polymers)
Entry Date(s):
Date Created: 20201007 Date Completed: 20210616 Latest Revision: 20210616
Update Code:
20240105
DOI:
10.1007/s00268-020-05808-4
PMID:
33025154
Czasopismo naukowe
Background: The goal of this article was to report the results about the efficacy of treatment of chronic mesh infection (CMI) after abdominal wall hernia repair (AWHR) in one-stage management, with complete mesh explantation of infected prosthesis and simultaneous reinforcement with a biosynthetic poly-4-hydroxybutyrate absorbable (P4HB) mesh.
Methods: This is a retrospective analysis of all patients that needed mesh removal for CMI between September 2016 and January 2019 at a tertiary center. Epidemiological data, hernia characteristics, surgical, and postoperative variables (Clavien-Dindo classification) of these patients were analyzed.
Results: Of the 32 patients who required mesh explantation, 30 received one-stage management of CMI. In 60% of the patients, abdominal wall reconstruction was necessary after the infected mesh removal: 8 cases (26.6%) were treated with Rives-Stoppa repair, 4 (13.3%) with a fascial plication, 1 (3.3%) with anterior component separation, and 1 (3.3%) with transversus abdominis release to repair hernia defects. Three Lichtenstein (10%) and 1 Nyhus repairs (3.3%) were performed in patients with groin hernias. The most frequent postoperative complications were surgical site occurrences: seroma in 5 (20%) patients, hematoma in 2 (6.6%) patients, and wound infection in 1 (3.3%) patient. During the mean follow-up of 34.5 months (range 23-46 months), the overall recurrence rate was 3.3%. Persistent, recurrent, or new CMIs were not observed.
Conclusions: In our experience, single-stage management of CMI with complete removal of infected prosthesis and replacement with a P4HB mesh is feasible with acceptable results in terms of mesh reinfection and hernia recurrence.

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