Our Summary

This research paper is about a study that looks into the effectiveness of Negative Pressure Wound Therapy (NPWT), a wound treatment technique, in treating infections that occur after a hernia repair surgery involving the use of a mesh. The main focus was to see how successful this treatment was in saving various types of meshes and in different positions.

The study involved sifting through major databases for articles related to NPWT, hernia, mesh infection, and more. Ten articles involving 265 patients undergoing NPWT for mesh infection after hernia repair were analyzed.

The results showed that NPWT was generally successful in saving the mesh in 76.2% of the cases. The highest success rates were seen with polypropylene mesh (93.5%), followed by Proceed mesh (83.3%). The least successful cases were seen with polyester mesh (0%) and ePTFE mesh (14/3%). The position of the mesh also affected the success rate, with meshes in the onlay position (82.6%) or retromuscular/sublay position (98.5%) having higher success rates than those in the IPOM position (55.6%).

In layman’s terms, the study concluded that the treatment for mesh infection after hernia repair should be specific to the type of mesh used, its position, and the severity of the infection. NPWT was found to be effective in saving meshes made from certain materials and placed in certain positions.

FAQs

  1. What is the effectiveness of Negative Pressure Wound Therapy (NPWT) in treating infections after hernia repair surgery involving the use of a mesh?
  2. How does the type of mesh and its position affect the success rate of NPWT in treating mesh infection after hernia repair?
  3. What conclusions were drawn from the study about the treatment for mesh infection after hernia repair surgery?

Doctor’s Tip

A helpful tip a doctor might give to a patient about hernia repair is to follow post-operative instructions carefully, including proper wound care and avoiding activities that could strain the repaired area. Additionally, if signs of infection develop, such as redness, swelling, or drainage from the wound, it is important to seek medical attention promptly to prevent complications.

Suitable For

Overall, patients who undergo hernia repair surgery involving the use of a mesh and develop an infection postoperatively may be recommended for treatment with Negative Pressure Wound Therapy. This treatment option has shown promising results in saving the mesh in a majority of cases, particularly when the mesh is made of polypropylene or Proceed material and placed in the retromuscular/sublay position. Patients with infections related to polyester or ePTFE meshes may not benefit as much from NPWT.

It is important for healthcare providers to consider the specific characteristics of the mesh and its position when deciding on the best treatment approach for patients with mesh infections after hernia repair surgery. By tailoring the treatment to the individual patient’s circumstances, healthcare providers can improve the chances of successfully saving the mesh and achieving a positive outcome for the patient.

Timeline

Before the hernia repair surgery, the patient typically experiences symptoms such as pain, discomfort, and a visible bulge at the site of the hernia. They may have difficulty performing everyday activities and may have tried non-surgical methods to alleviate their symptoms.

After the hernia repair surgery, the patient may experience some pain and discomfort at the surgical site, as well as limited mobility. They will be advised to avoid heavy lifting and strenuous activities for a period of time to allow for proper healing. The incision site may be sore and swollen, and the patient will need to follow post-operative care instructions provided by their healthcare provider.

In the case of a mesh infection following hernia repair surgery, the patient may experience symptoms such as increased pain, redness, swelling, and drainage at the surgical site. In this situation, the patient may undergo treatment with Negative Pressure Wound Therapy (NPWT) to help manage the infection and potentially save the mesh. This treatment involves applying negative pressure to the wound to remove excess fluid and promote healing.

Overall, the timeline for a patient before and after hernia repair involves experiencing symptoms related to the hernia, undergoing surgery to repair the hernia, and potentially receiving additional treatment such as NPWT in the case of a mesh infection. Proper care and follow-up with healthcare providers are essential for a successful recovery.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about hernia repair:

  1. What type of mesh will be used in my hernia repair surgery?
  2. What position will the mesh be placed in during the surgery?
  3. What are the potential risks of developing an infection after the surgery?
  4. How will you monitor for any signs of infection post-surgery?
  5. If an infection does occur, what treatment options are available?
  6. Is Negative Pressure Wound Therapy (NPWT) a potential treatment option for mesh infection post-surgery?
  7. What are the success rates of NPWT in saving the mesh in cases of infection?
  8. Are there any specific factors, such as the type of mesh or its position, that can affect the success of NPWT in treating mesh infection?
  9. How long does the NPWT treatment typically last, and what is the recovery process like?
  10. Are there any alternative treatments or therapies available for mesh infection after hernia repair surgery?

Reference

Authors: Li J, Wang Y, Shao X, Cheng T. Journal: ANZ J Surg. 2022 Oct;92(10):2448-2456. doi: 10.1111/ans.18040. Epub 2022 Sep 15. PMID: 36106686