Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

Moreschi, Alexandre Heitor; Neto, Amarílio Vieira de Macedo; Barbosa, Gilberto Venossi; Saueressig, Mauricio Guidi

doi:10.1590/s1806-37132008000900004

Cited by 12 publications

(2 citation statements)

References 28 publications

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“…As mentioned above, we sutured the greater omentum to the abdominal wall to cover the exposed preperitoneal space. The greater omentum is effectively used in various surgical fields, including contaminated ones, other than gastrointestinal surgery, such as thoracic and cardiovascular surgeries [ 12 , 13 ]. In the present case, we closed the peritoneal defect using the greater omentum and the patient experienced no complications postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Removal of an Infected Mesh Following TEP Procedure for Femoral Hernia with Omental Patch Closure of a Peritoneal Defect

2023

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Patient: Female, 76-year-old Final Diagnosis: Mesh infection following femoral hernia repair Symptoms: Pain • redness • swelling Clinical Procedure: Laparoscopic surgery Specialty: Surgery Objective: Unusual clinical course Background: Mesh infection following inguinal hernia repair is rare, and mesh removal is mandatory. However, the laparoscopic approach is challenging to perform. Here, we present a case of laparoscopic repair of a mesh infection using a totally extraperitoneal approach (TEP). Case Report: A 76-year-old woman underwent repair of a right femoral hernia via TEP approach using a prosthetic mesh with unabsorbable tacks. A month and a half after the surgery, she reported pain in the right groin. Computed tomography revealed a subcutaneous abscess in the right groin. We suspected mesh infection and initially chose conservative management, which included percutaneous drainage and systemic antibiotic administration. Her symptoms temporarily resolved; however, symptom relapse and purulent discharge from the right groin were observed. We performed laparoscopic removal of the infected mesh and all tacks via the transabdominal preperitoneal approach. A drain was placed in the infected preperitoneal space, and the peritoneal defect was covered using the greater omentum. The patient’s postoperative course was uneventful, and she was discharged on postoperative day 20. Infection relapse, symptoms of femoral hernia, and adhesive intestinal obstruction have not been observed. Conclusions: A laparoscopic approach for mesh infection after TEP hernia repair is feasible, even if the mesh is fixed using a tack. Greater omental use for peritoneal defects is useful in clinical situations associated with a contaminated surgical field.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Removal of an Infected Mesh Following TEP Procedure for Femoral Hernia with Omental Patch Closure of a Peritoneal Defect

2023

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“…The use of the greater omentum in the treatment of the mediastinitis and deep sternal wound infection has been described in the literature and its immunological and angiogenetic properties can prevent the further extension of local infection and facilitate the primary closure of the superficial tissues, leading to the healing of the sternal wound [4]. …”

Section: Discussionmentioning

confidence: 99%

Complicated sternal dehiscence treated with the strasbourg thoracic osteosyntheses system (STRATOS) and the transposition of greater omentum: a case report

Ceresa

Casablanca

Patanè

2010

J Cardiothorac Surg

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Sternal dehiscence is a serious complication after cardiac surgery. Sternal refixation, performed by simple rewiring or techniqual modification of rewiring as described by Robicsek, can fail, overall when the bone quality is poor or the sternum is completely destroyed. The sternal closure systems, consisting of plates, screws or rib clips and titanium bars, have been recently introduced to treat the complicated sternal dehiscence. We describe for the first time the use of the Strasbourg Thoracic Osteosyntheses System (STRATOS) and the greater omentum, to treat a complicated sternal dehiscence, causing chest pain and respiratory failure.

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Efficacy of sternocleidomastoid muscle flap in reducing anastomotic mediastinal/pleural cavity leak

et al. 2022

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Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

Cited by 12 publications

References 28 publications

Laparoscopic Removal of an Infected Mesh Following TEP Procedure for Femoral Hernia with Omental Patch Closure of a Peritoneal Defect

Laparoscopic Removal of an Infected Mesh Following TEP Procedure for Femoral Hernia with Omental Patch Closure of a Peritoneal Defect

Complicated sternal dehiscence treated with the strasbourg thoracic osteosyntheses system (STRATOS) and the transposition of greater omentum: a case report

Efficacy of sternocleidomastoid muscle flap in reducing anastomotic mediastinal/pleural cavity leak

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