Our Summary

This research paper is about a problem that can occur after a certain type of hernia repair surgery, where the surgical mesh used in the procedure gets infected. This is a difficult issue to deal with and there’s no agreed-upon best way to handle it. The researchers decided to look at all the available studies on the use of a certain treatment called negative pressure wound therapy (NPWT) for managing these infections.

They looked at 33 studies from one database (PubMed) and 16 from another (EMBASE), and they found that NPWT was used in 230 patients across 9 of these studies. In about 85% of these cases, the infected mesh could be saved and didn’t need to be removed. They also found that the type and location of the mesh affected how likely it was to be saved.

The researchers concluded that NPWT is a good way to treat these mesh infections and that in most cases, the mesh can be saved. However, they also say that more studies with more patients are needed to confirm their findings.

FAQs

  1. What is the problem that can occur after a certain type of hernia repair surgery?
  2. What is negative pressure wound therapy (NPWT) and how is it used in treating mesh infections?
  3. What were the findings of the research on the use of NPWT for managing mesh infections in hernia repair surgeries?

Doctor’s Tip

A doctor might tell a patient about hernia repair that it’s important to follow post-operative care instructions carefully to reduce the risk of complications, such as infection. This may include avoiding heavy lifting, taking prescribed medications, and keeping the surgical site clean and dry. They may also advise the patient to contact them immediately if they notice any signs of infection, such as redness, swelling, or pus at the surgical site.

Suitable For

Patients who are typically recommended hernia repair surgery include those who are experiencing discomfort or pain due to a hernia, those whose hernia is causing complications such as bowel obstruction or strangulation, and those who have a hernia that is affecting their daily activities or quality of life. Additionally, patients with certain risk factors such as obesity, smoking, or a family history of hernias may also be recommended for hernia repair.

Timeline

Before hernia repair surgery, a patient may experience symptoms such as pain, swelling, and a visible bulge or lump in the affected area. They may also have difficulty with physical activities and may experience discomfort while coughing or lifting heavy objects.

After hernia repair surgery, the patient may experience some pain and discomfort at the surgical site, as well as bruising and swelling. They will be advised to avoid strenuous activities for a certain period of time and to follow post-operative care instructions provided by their healthcare provider. Over time, the patient should experience a gradual improvement in their symptoms and be able to resume normal activities without any issues.

In the event that the surgical mesh used in the hernia repair surgery becomes infected, the patient may experience symptoms such as fever, redness, warmth, and increased pain at the surgical site. In this case, additional treatment may be necessary, such as the use of negative pressure wound therapy (NPWT) to manage the infection and potentially save the mesh. Additional follow-up appointments and monitoring may be required to ensure the infection is properly treated and the patient’s recovery is successful.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hernia repair surgery using surgical mesh?
  2. How common is it for the surgical mesh to become infected after hernia repair surgery?
  3. What are the symptoms of an infected mesh after hernia repair surgery?
  4. How is an infected mesh typically diagnosed?
  5. What are the treatment options available for managing an infected mesh after hernia repair surgery?
  6. How does negative pressure wound therapy (NPWT) work in treating infected mesh after hernia repair surgery?
  7. What are the success rates of NPWT in saving the infected mesh?
  8. Are there any specific factors that can affect the effectiveness of NPWT in treating an infected mesh?
  9. What are the potential long-term implications of having an infected mesh after hernia repair surgery?
  10. Are there any alternative treatments or strategies for managing an infected mesh after hernia repair surgery?

Reference

Authors: Bueno-Lledó J, Martinez-Hoed J, Bonafe-Diana S, Pous-Serrano S. Journal: World J Surg. 2023 Jun;47(6):1495-1502. doi: 10.1007/s00268-023-06943-4. Epub 2023 Feb 21. PMID: 36802233