腹股沟疝无张力疝修补术后迟发性深部感染的外科治疗

Surgical treatment of delayed deep infection after tension-free repair of inguinal hernia

目的探讨腹股沟疝无张力修补术后迟发性深部感染的外科治疗体会。方法回顾性分析2012年6月至2018年6月,苏州工业园区星湖医院30例行腹股沟疝无张力修补术后出现迟发性深部感染患者的临床资料,并对患者的一般情况进行研究分析。30例患者均进行手术治疗,清创、取出补片、敞开创面、负压封闭引流、定期换药,观察治疗后患者的愈合情况。结果所有患者给予清创手术后取出补片,30例患者均获甲级愈合,住院时间10~35 d,平均住院时间为(22.3±2.4)d,术后对患者进行为期8~12个月的病情随访,平均(9.2±1.5)个月,术后无疝复发。结论通过手术取出补片,敞开创面,负压封闭引流,定期换药,及时对症处理可有效治疗腹股沟无张力修补术后迟发性深部感染,减轻患者痛苦。术前完善相关检查,术中要求严格执行无菌操作,规范的手术操作以及合适补片的选择是预防补片感染的关键。

Objective To explore the experience of surgical treatment of delayed deep infection after tension-free repair of inguinal hernia. Methods The clinical data of 30 patients with delayed deep infection after tension-free inguinal hernia repair in Xinghu Hospital of Suzhou Industrial Park from June 2012 to June 2018 were retrospectively analyzed, and the general situation of the patients was analyzed. All 30 patients underwent surgical treatment, including debridement, mesh removal, open wound, negative pressure sealing drainage, regular dressing change and observed the healing of patients after treatment. Result All patients were treated with debridement and the meshes were removed. All 30 patients were primarily healed. The hospitalization time was 10 to 35 days. The average hospitalization time was (22.3±2.4) days. The patients were followed up for 8 to 12 months after debridement. The average time was (9.2±1.5) months. There was no recurrence of hernia. Conclusion Delayed deep infection after tension-free inguinal repair can be effectively treated by surgical removal of meshes, open wounds, negative pressure sealing drainage, regular dressing change and timely symptomatic treatment. Perfect preoperative examination, strict aseptic operation during operation, standardized operation and appropriate mesh selection are the key to prevent mesh infection.