Abstract

RUIZ-TOVAR, Jaime; REY IBARRA, Antonio  and  DEVESA MUGICA, José Manuel. Conservative management of hernia mesh infection. Rev. gastroenterol. Perú [online]. 2011, vol.31, n.4, pp.386-388. ISSN 1022-5129.

INTRODUCTION: Standard management of infected mesh advocates its removal, but this often results in a larger hernia than at the time of original repair. In this article we describe a novel approach to manage conservatively an infected prosthetic mesh. Patient and Methods: Mesh infection rate at our institution was 1%. We describe 3 cases (inguinal, ventral and parastomal hernias) that presented prosthetic mesh infections. All the cases were satisfactorily managed with a conservative approach, consisting in wound opening and pressurized wound irrigation with gentamicin (80mg/8hours) and intravenous infusion of Amoxicilin/Clavulanic acid (875mg+125mg/8hours) during 7 days, achieving sterile cultures of the mesh surface in all the cases. A 3rd intention closure of the wound was performed. There is no clinical evidence of recurrent infection in any case. Conclusion: Conservative management of mesh infection, including drainage, antibiotic irrigation and wound closure, is a potential alternative to mesh removal.

Keywords : Mesh infection; hernia; conservative treatment; gentamicin irrigation; third intention closure.

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