Bacteria in hernia sac: an important risk fact for surgical site infection after incarcerated hernia repair

Yang, Linhua; Wang, H.; Liang, Xiaowen; Chen, T.; Chen, Wei; Song, Yan; Wang, J.

doi:10.1007/s10029-014-1275-z

Cited by 34 publications

(23 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prosthetic material is contraindicated for infected or contaminated abdominal wall defects; hence, the repair of such defects is challenging [1, 2]. Infected incisional hernias have been treated using autologous tissue grafts, and a previous study reported that treatment with a fascia lata patch is safe and effective [3].…”

Section: Introductionmentioning

confidence: 99%

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

Shinmoto¹,

Miyanari²,

Sugihara³

et al. 2017

surg case rep

View full text Add to dashboard Cite

BackgroundFournier gangrene due to advanced rectal cancer is a rapidly progressive gangrene of the perineum and buttocks. Emergency surgical debridement of necrotic tissue is crucial, and secondary surgery to resect tumors is necessary for wound healing. However, pelvic exenteration damages the pelvic floor, increasing the likelihood of herniation of internal organs into the infectious wound. The management of pelvic exenteration for rectal cancer with Fournier gangrene has not yet been established. We herein describe the use of a fascia lata free flap in pelvic exenteration for rectal cancer with Fournier gangrene.Case presentationA 66-year-old male who had undergone colostomy for large bowel obstruction due to advanced rectal cancer and continued chemotherapy was referred to our hospital for Fournier gangrene resulting from chemotherapy. Emergency surgical debridement was performed, and the infectious wound around the rectal cancer was treated with intravenous antibiotic agents postoperatively. However, the tumor was exposed by the wound, and exudate persisted. Pelvic exenteration was performed due to tumor infiltration into the bladder and prostate. Tumor resection resulted in a defect in the pelvic floor. A fascia lata free flap (15 × 9 cm) obtained from the left thigh was fixed to the edge of the peritoneum and ileal conduit to close the defect in the pelvic floor and prevent small bowel herniation into the resected space. There was no intraabdominal inflammation or bowel obstruction postoperatively, and outpatient chemotherapy was continued.ConclusionsSurgical repair with a fascia lata free flap to close the defect in the pelvic floor led to a good clinical outcome for pelvic exenteration in a patient with Fournier gangrene due to advanced rectal cancer.

show abstract

Section: Introductionmentioning

confidence: 99%

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

Shinmoto¹,

Miyanari²,

Sugihara³

et al. 2017

surg case rep

View full text Add to dashboard Cite

show abstract

“…E. coli was indeed cultured from specimens of 1 and 3 patients in the OPR and OSR groups, respectively, via culturing of the hernia sac fluid. Some researchers have analysed the culture of bacteria in the incarcerated hernia sac and found that the most common bacteria in the hernia sac was E. coli 21 .…”

Section: Discussionmentioning

confidence: 99%

A retrospective cohort study of open preperitoneal repair versus open suture repair for the treatment of emergency femoral hernia

Liu

Zheng

et al. 2020

Sci Rep

View full text Add to dashboard Cite

to compare the outcomes of open preperitoneal repair (opR) with the use of mesh and open suture repair (oSR) without mesh via inguinal approach for the treatment of emergency femoral hernia (fH). the primary outcome was the postoperative complication and the secondary outcomes were the recurrence rate of FH and the postoperative comfort level at the surgical site. 104 patients with emergency FHs were included, of whom 51 patients were treated with OPR, 53 patients were treated with OSR. Between the two groups, no significant difference was found in surgical site infection (SSI) (p = 0.801) or seroma (P = 0.843), while there was significant difference in the improvement of comfort at the surgical site (p = 0.013). The results of the 2-year follow-up demonstrated 1 and 8 cases of recurrence in the OPR and OSR group respectively, which was statistically significant (HR, 8.193 [95% CI, 1.024 to 65.547], P = 0.047). Compared with OSR, OPR with the use of mesh did not increase the risk of SSi and was safe to apply even under the condition of an emergency fH operation with intestine resection; opR could reduce the recurrence rate of fH and improve the comfort at the surgical site.The incidence of femoral hernia is not high, accounting for approximately 2-4% of all groin hernias 1,2 , but it is extremely easy for femoral hernias (FHs) to incarcerate and/or strangulate 3,4 , and patients need emergency surgery after incarceration and/or strangulation 5,6 . The surgical methods include tissue suture repair and tension-free repair with different kinds of meshes. Clinical guidelines do not strongly recommend tension-free repair with mesh because this approach may cause surgical site infection (SSI), especially in patients who undergo intestinal resection 7,8 . At present, with the improvement of mesh materials, there have been continuous reports of the safe use of mesh in the repair of incarcerated and/or strangulated groin hernias or even in the condition of intestinal resection without the occurrence of serious complications such as mesh-related infection 9-11 .However, cohort studies comparing open mesh tension-free repair and open suture repair for emergency femoral hernias via the inguinal approach have rarely been reported. The purpose of this study was to evaluate the feasibility of open preperitoneal repair (OPR) for emergency FHs using UHS meshes by comparing the outcomes with those of open suture repair (OSR) for the treatment of emergency FHs. patients and Methods ethics statement. This retrospective cohort study was approved by the Medical Ethics Committee of Ganzhou People's Hospital, and the methods were carried out in accordance with the approved guidelines.patients. By referencing the medical records, consecutive patients with a primary diagnosis of FH treated between 2011 and 2017 were identified. Patients who underwent emergency FH repair via OPR with the use of UHS mesh or OSR without the use of mesh were selected and divided into two groups (the OPR group and OSR group) according to the repair method.

show abstract

“…On the other hand, the rate of recurrence was significantly lower in the mesh treated group [33]. Yang et al reviewed postoperative surgical site infection rate in incarcerated inguinal hernia and found that 4 out of 103 cases of mesh repair and 5 out of 9 suture repairs developed surgical site infection [34]. Unsurprisingly, they also found that the risk of surgical site infection is significantly higher in cases involving bowel resection, supporting Nguyen's proposal that if appendectomy is not performed (in the case of healthy appendix), de Garengeot's hernias can be repaired with mesh without significantly increased risk of infection [30].…”

Section: Discussionmentioning

confidence: 99%

De Garengeot’s Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia

Jin

Imtiaz

Nnajiuba

et al. 2016

Case Reports in Surgery

View full text Add to dashboard Cite

We present two cases of incarcerated de Garengeot's hernia. This anatomical phenomenon is thought to occur in as few as 0.5% of femoral hernia cases and is a rare cause of acute appendicitis. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. In earlier reports operative treatment invariably involves simultaneous appendicectomy and femoral hernia repair. Both patients were correctly diagnosed preoperatively with computed tomography (CT). Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. Both patients recovered without complications. Routine diagnostic imaging modalities such as ultrasonography and standard CT have previously shown little success in identifying de Garengeot's hernia preoperatively. We believe this to be the first documented case of CT with concurrent oral and intravenous contrast being used to confidently and correctly diagnose de Garengeot's hernia prior to surgery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.

show abstract

Bacteria in hernia sac: an important risk fact for surgical site infection after incarcerated hernia repair

Abstract: Gut-sourced E. coli is an important common organisms associated with SSI after incarcerated hernia repair. Prosthetic mesh could be used when no bowel resection is performed, duration of symptoms less than 24 h and fluid hernia sac is clear.

Cited by 34 publications

References 20 publications

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

A fascia lata free flap in pelvic exenteration for Fournier gangrene due to advanced rectal cancer: a case report

A retrospective cohort study of open preperitoneal repair versus open suture repair for the treatment of emergency femoral hernia

De Garengeot’s Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia

Contact Info

Product

Resources

About