VAC-instillation therapy in abdominal mesh exposure: a novel indication

García-Ruano, Ángela; Deleyto, Esther; Garcia-Fernandez, Sebastian

doi:10.1016/j.jss.2016.08.030

Cited by 15 publications

(23 citation statements)

References 23 publications

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“…To our knowledge, this is the first clinical case study utilizing the NPWT with instillation system for the complete healing of a large abdominal wall defect following an incarcerated parastomal hernia repair with mesh infection. The removal of gangrenous bowel and the emergency setting for this case were risk factors for postoperative complications [9], which have been previously published following hernia repair or abdominal wall surgery. These risk factors include age > 70 years, concurrent bowel surgery, previous hernia repair, diameter > 10 cm, emergency surgery, and previous cancer diagnosis [9,15].…”

Section: Discussionmentioning

confidence: 99%

Negative Pressure Wound Therapy with Instillation as Conservative Management for a Large Abdominal Wound Following Incarcerated Parastomal Hernia Repair

Raykha¹,

Botros²,

Roden³

et al. 2018

Cureus

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Parastomal herniation is a common complication following stoma creation, necessitating surgical repair in up to one-quarter of cases, including emergency cases of incarceration or strangulation. Following hernia repair with or without mesh placement, surgical sites are at risk of infection post-operatively and this is typically resolved by removing the mesh, which can be technically challenging. Few studies have assessed conservative management options for these types of cases. Here, we present a case where negative pressure wound therapy (NPWT) with instillation was utilized for secondary intention healing of a large abdominal wound (20 cm x 23 cm x 5 cm) following mesh infection post-parastomal hernia repair. The patient’s wound was completely healed after eight weeks and she had no long-term complications at the one-year follow-up. NPWT with instillation is an option for the conservative management of large abdominal wounds, which can be considered on a case-by-case basis.

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Section: Discussionmentioning

confidence: 99%

Negative Pressure Wound Therapy with Instillation as Conservative Management for a Large Abdominal Wound Following Incarcerated Parastomal Hernia Repair

Raykha¹,

Botros²,

Roden³

et al. 2018

Cureus

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“…A trial of mesh salvage is almost always appropriate when the patient is stable and not septic. Once necrotic tissue has been fully debrided, negative pressure wound therapy can be used to encourage granulation formation through the mesh pores, ultimately covering the mesh [28] . In animal models, the degree and speed of tissue integration is greatest with macroporous (1.8 mm × 3.4 mm pore size) compared to microporous mesh (0.9 mm × 1 mm pore size) [29] .…”

Section: Mesh Exposurementioning

confidence: 99%

Management of post-operative complications in open ventral hernia repair

O’Connor¹,

Carbonell²

2019

PAR

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Hernia repair is the most common general surgical procedure performed in the United States; however, historically, there has been a surprising lack of consensus regarding hernia complications and their management. The development of international, prospectively-collected databases such as the Americas Hernia Society Quality Collaborative has introduced a new era of evidence-based practice around the prevention and management of these complications. This review seeks to equip surgeons with evidence-based techniques for prevention and management of the most common complications of open ventral hernia repair.

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“…In our present study, all patients remained in hospital till stitch removal. However, a retrospective study by Garcia-Ruano et al on 45 patients showed no statistical difference in hospital stay between the two groups [27]. In future cases, we plan to discharge our patients after first session of NPWT that is within 3-4 days of diagnosis of wound infection.…”

Section: Discussionmentioning

confidence: 96%

Management of non-absorbable mesh infection after hernia repair by negative pressure wound therapy

Faruq¹,

Raihan²,

Haque³

2019

IMC J Med Sci

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Background and objectives: Mesh infection following hernia repair has previously often resulted in removal of mesh. The aim of this study was to evaluate if negative pressure wound therapy (NPWT) can be used to treat such complications and preserve the mesh. Materials and method: A prospective study was carried in the Department of Surgery, BIRDEM General Hospital from January 2017 to January 2019. Patients with deep wound infection and exposed infected mesh after hernioplasty were included in the study. Patients’ demographics, existing comorbidities and outcome were recorded. All patients were treated with NPWT till the wound was covered with healthy granulation tissue and closed. Results: NPWT was used to treat 7 patients with mesh infection following hernia repair. There was 2 male and 5 female cases and age ranged from 38-58 years. With NPWT the mesh in 6 patients (86%) out of 7 could be completely salvaged and wound closed with secondary suturing. However, in 1 patient although the mesh covered with granulation tissue by NPWT and wound was closed; but it had to be partly removed later on due to development of chronic discharging sinus 20 days after stitch removal. Conclusion: The study demonstrated that NPWT was a useful technique for the treatment and preservation of infected mesh after hernia repair. IMC J Med Sci 2019; 13(1): 008

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VAC-instillation therapy in abdominal mesh exposure: a novel indication

Cited by 15 publications

References 23 publications

Negative Pressure Wound Therapy with Instillation as Conservative Management for a Large Abdominal Wound Following Incarcerated Parastomal Hernia Repair

Negative Pressure Wound Therapy with Instillation as Conservative Management for a Large Abdominal Wound Following Incarcerated Parastomal Hernia Repair

Management of post-operative complications in open ventral hernia repair

Management of non-absorbable mesh infection after hernia repair by negative pressure wound therapy

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