• 1.首都醫(yī)科大學附屬北京朝陽醫(yī)院疝和腹壁外科(北京 100043);;
  • 2.首都醫(yī)科大學附屬北京朝陽醫(yī)院(西院區(qū))病案統(tǒng)計科(北京 100043);

目的  探討腹股溝疝補片修補術后補片感染的外科處理方法和經驗。
方法  回顧性分析北京朝陽醫(yī)院疝和腹壁外科2011年1月至2012年6月期間收治的67例腹股溝疝補片修補術后發(fā)生補片感染患者的臨床資料,對患者的傷口愈合情況加以分析。
結果  67例患者均行清除感染補片及周圍感染組織,未再重新放置補片,均行一期全層縫合傷口,同時放置傷口引流管。均成功清除了感染的補片;術后住院時間10~25d,平均16d;術后傷口一期愈合51例,拆線后傷口存在淺部感染、經局部換藥后延期愈合16例。術后66例患者獲訪,隨訪時間為6~24個月(平均20個月)。隨訪期間,均無切口下積液、傷口感染、腸瘺、術后疼痛等并發(fā)癥發(fā)生,無腹股溝疝復發(fā)。
結論  腹股溝疝補片修補術后補片感染的外科處理十分復雜,采用去除補片、徹底清創(chuàng)、一期縫合及放置傷口引流管的綜合手術治療方法可以獲得比較滿意的療效。

引用本文: 孫立,申英末,陳杰,劉素君,陳富強,楊桂月. 腹股溝疝補片修補術后補片感染外科處理方法的研究. 中國普外基礎與臨床雜志, 2013, 20(12): 1341-1343. doi: 復制

1. 申英末, 陳杰, 王振軍, 等. 疝修補材料的發(fā)展與新進展[J]. 中華疝和腹壁外科雜志:電子版, 2007, 1(1):56-59.
2. 孫立, 陳杰, 申英末, 等. 精索護墊補片在腹股溝疝修補術中的應用研究[J]. 中國現(xiàn)代醫(yī)學雜志, 2012, 22(31):101-104.
3. 顧巖. 腹壁疝人工合成補片植入所致感染的防治[J]. 外科理論與實踐, 2010, 15(6):586-589.
4. 劉飛德, 李基業(yè), 姚勝, 等. 腹壁疝補片修補術后感染的外科處理[J]. 中國普外基礎與臨床雜志, 2011, 18(12):1292-1295.
5. 陳健民, 劉誼和, 鄭涵予. 無張力疝修補術后切口感染分析[J]. 中華疝和腹壁外科雜志:電子版, 2008, 2(3):334-336.
6. Jezupovs A, Jezupors A, Mihelsons M. The analysis of infection after polypropylene mesh repair of abdominal wall hernia[J]. World J Surg, 2006, 30(12):2270-2278.
7. 朱健. 腹股溝疝無張力修補的認識進展[J]. 實用醫(yī)學雜志, 2005, 21(2):215-216.
8. Salvilla SA, Thusu S, Panesar SS. Analysing the benefits of lapa-roscopic hernia repair compared to open repair:a meta-analysis of observational studies[J]. J Minim Access Surg, 2012, 8(4):111-117.
9. Penttinen R, Grönroos JM. Mesh repair of common abdominal hernias:a review on experimental and clinical studies[J]. Hernia,2008, 12(4):337-344.
10. Alaedeen DI, Lipman J, Medalie D, et al. The single-staged approach to the surgical management of abdominal wall hernias in contaminated fields[J]. Hernia, 2007, 11(1):41-45.
11. Brown RH, Subramanian A, Hwang CS, et al. Comparison of infectious complications with synthetic mesh in ventral hernia repair[J]. Am J Surg, 2013, 205(2):182-187.
12. Hawn MT, Gray SH, Snyder CW, et al. Predictors of mesh expl-antation after incisional hernia repair[J]. Am J Surg, 2011, 202(1):28-33.
13. Zuvela M, Antic A, Bajec D, et al. Diagnosis of mesh infectionafter abdominal wall hernia surgery—role of radionuclide methods[J]. Hepatogastroenterology, 2011, 58(110-111):1455-1460.
14. Blatnik JA, Krpata DM, Novitsky YW, et al. Does a history of wound infection predict postoperative surgical site infection after ventral hernia repair?[J]. Am J Surg, 2012, 203(3):370-374.
15. Cobb WS, Carbonell AM, Kalbaugh CL, et al. Infection risk of open placement of intraperitoneal composite mesh[J]. Am Surg, 2009, 75(9):762-767.
16. Aguilar B, Chapital AB, Madura JA, et al. Conservative manag-ement of mesh-site infection in hernia repair[J]. J Laparoendosc Adv Surg Tech A, 2010, 20(3):249-252.
17. Eriksen JR, Gögenur I, Rosenberg J. Choice of mesh for laparoscopic ventral hernia repair[J]. Hernia, 2007, 11(4):481-492.
18. Hawn MT, Snyder CW, Graham LA, et al. Long-term follow-upof technical outcomes for incisional hernia repair[J]. J Am Coll Surg, 2010, 210(5):648-655.
19. Sabbagh C, Verhaeghe P, Brehant O, et al. Partial removal of infected parietal meshes is a safe procedure[J]. Hernia, 2012, 16(4):445-449.
20. Greenberg JJ. Can infected composite mesh be salvaged?[J]. Hernia, 2010, 14(6):589-592.
21. Halaweish I, Harth K, Broome AM, et al. Novel in vitro model for assessing susceptibility of synthetic hernia repair meshes to staphylococcus aureus infection using green fluorescent protein-labeled bacteria and modern imaging techniques[J]. Surg Infect (Larchmt), 2010, 11(5):449-454.
22. Tolino MJ, Tripoloni DE, Ratto R, et al. Infections associated with prosthetic repairs of abdominal wall hernias:pathology, management and results[J]. Hernia, 2009, 13(6):631-637.
23. Miller G. Promising agent emerging to battle mesh infections[J]. Gen Surg News, 2010, 37(1):16-17.
24. 楊帆. 無張力疝修補術后并發(fā)癥分析[J]. 中華疝和腹壁外科雜志:電子版, 2013, 7(1):7-9.
25. 李基業(yè). 腹壁切口疝合成補片修補的感染原因及防治[J]. 外科理論與實踐, 2013, 18(3):202-206.
  1. 1. 申英末, 陳杰, 王振軍, 等. 疝修補材料的發(fā)展與新進展[J]. 中華疝和腹壁外科雜志:電子版, 2007, 1(1):56-59.
  2. 2. 孫立, 陳杰, 申英末, 等. 精索護墊補片在腹股溝疝修補術中的應用研究[J]. 中國現(xiàn)代醫(yī)學雜志, 2012, 22(31):101-104.
  3. 3. 顧巖. 腹壁疝人工合成補片植入所致感染的防治[J]. 外科理論與實踐, 2010, 15(6):586-589.
  4. 4. 劉飛德, 李基業(yè), 姚勝, 等. 腹壁疝補片修補術后感染的外科處理[J]. 中國普外基礎與臨床雜志, 2011, 18(12):1292-1295.
  5. 5. 陳健民, 劉誼和, 鄭涵予. 無張力疝修補術后切口感染分析[J]. 中華疝和腹壁外科雜志:電子版, 2008, 2(3):334-336.
  6. 6. Jezupovs A, Jezupors A, Mihelsons M. The analysis of infection after polypropylene mesh repair of abdominal wall hernia[J]. World J Surg, 2006, 30(12):2270-2278.
  7. 7. 朱健. 腹股溝疝無張力修補的認識進展[J]. 實用醫(yī)學雜志, 2005, 21(2):215-216.
  8. 8. Salvilla SA, Thusu S, Panesar SS. Analysing the benefits of lapa-roscopic hernia repair compared to open repair:a meta-analysis of observational studies[J]. J Minim Access Surg, 2012, 8(4):111-117.
  9. 9. Penttinen R, Grönroos JM. Mesh repair of common abdominal hernias:a review on experimental and clinical studies[J]. Hernia,2008, 12(4):337-344.
  10. 10. Alaedeen DI, Lipman J, Medalie D, et al. The single-staged approach to the surgical management of abdominal wall hernias in contaminated fields[J]. Hernia, 2007, 11(1):41-45.
  11. 11. Brown RH, Subramanian A, Hwang CS, et al. Comparison of infectious complications with synthetic mesh in ventral hernia repair[J]. Am J Surg, 2013, 205(2):182-187.
  12. 12. Hawn MT, Gray SH, Snyder CW, et al. Predictors of mesh expl-antation after incisional hernia repair[J]. Am J Surg, 2011, 202(1):28-33.
  13. 13. Zuvela M, Antic A, Bajec D, et al. Diagnosis of mesh infectionafter abdominal wall hernia surgery—role of radionuclide methods[J]. Hepatogastroenterology, 2011, 58(110-111):1455-1460.
  14. 14. Blatnik JA, Krpata DM, Novitsky YW, et al. Does a history of wound infection predict postoperative surgical site infection after ventral hernia repair?[J]. Am J Surg, 2012, 203(3):370-374.
  15. 15. Cobb WS, Carbonell AM, Kalbaugh CL, et al. Infection risk of open placement of intraperitoneal composite mesh[J]. Am Surg, 2009, 75(9):762-767.
  16. 16. Aguilar B, Chapital AB, Madura JA, et al. Conservative manag-ement of mesh-site infection in hernia repair[J]. J Laparoendosc Adv Surg Tech A, 2010, 20(3):249-252.
  17. 17. Eriksen JR, Gögenur I, Rosenberg J. Choice of mesh for laparoscopic ventral hernia repair[J]. Hernia, 2007, 11(4):481-492.
  18. 18. Hawn MT, Snyder CW, Graham LA, et al. Long-term follow-upof technical outcomes for incisional hernia repair[J]. J Am Coll Surg, 2010, 210(5):648-655.
  19. 19. Sabbagh C, Verhaeghe P, Brehant O, et al. Partial removal of infected parietal meshes is a safe procedure[J]. Hernia, 2012, 16(4):445-449.
  20. 20. Greenberg JJ. Can infected composite mesh be salvaged?[J]. Hernia, 2010, 14(6):589-592.
  21. 21. Halaweish I, Harth K, Broome AM, et al. Novel in vitro model for assessing susceptibility of synthetic hernia repair meshes to staphylococcus aureus infection using green fluorescent protein-labeled bacteria and modern imaging techniques[J]. Surg Infect (Larchmt), 2010, 11(5):449-454.
  22. 22. Tolino MJ, Tripoloni DE, Ratto R, et al. Infections associated with prosthetic repairs of abdominal wall hernias:pathology, management and results[J]. Hernia, 2009, 13(6):631-637.
  23. 23. Miller G. Promising agent emerging to battle mesh infections[J]. Gen Surg News, 2010, 37(1):16-17.
  24. 24. 楊帆. 無張力疝修補術后并發(fā)癥分析[J]. 中華疝和腹壁外科雜志:電子版, 2013, 7(1):7-9.
  25. 25. 李基業(yè). 腹壁切口疝合成補片修補的感染原因及防治[J]. 外科理論與實踐, 2013, 18(3):202-206.