疝修补术后补片感染一期手术治疗35例报告

目的总结疝修补术后补片感染一期手术取出补片加缝合关闭伤口和缺损的诊疗经验。方法2014年6月至2019年6月疝修补术后补片感染患者35例。通过开放手术取出感染补片,放置通畅引流后一期缝合关闭。收集并分析患者相关临床资料。结果35例患者中男24例,女11例;切口疝8例,腹股沟疝23例,脐疝3例,造口旁疝1例。其中合并肠瘘6例,补片取出后均未再放置补片,予以一期缝合修补关闭缺损。术中肠管损伤2例,膀胱损伤l例,均于术中完成修补,无大血管损伤病例。平均手术时间(95.4±27.5)min,平均术中出血量(43.7±26.2)cm^3,平均住院时间(14.6±4.3)d,术后残余感染1例,无术后出血、肠梗阻等严重并发症。随访(29.8±15.8)个月,随访期内疝复发1例。结论疝修补手术术后感染补片取出一期缝合关闭伤口和缺损是安全有效的治疗方式。

Objective To summarize the clinical experience of one-stage closure surgeries for mesh infection after hernia repairs.Methods From June 2014 to June 2019,35 patients with mesh infections after hermnia repairs were admitted to our hospital.The infected meshes were removed through open surgeries,and one-stage closure procedures were performed after drainage placement.The relevant clinical data of patients were collected and analyzed.Results Among the 35 patients,24 were males,11 were females,8 were incisional hermias,23 were inguinal hermias,3 were umbilical hernias and 1 was paracostomy hernia.Among them,there were 6 cases with intestinal fistula.No new mesh was placed in the surgery,and the abdominal wall defect was closed by suture simultaneously.There were 2 cases of intestinal injury and 1 case of bladder injury during the operation.The average operating time was(95.4±27.5)min,the average intraoperative bleeding volume was(43.7±26.2)cm^3,the average hospitalization time was(14.6±4.3)days,and there was I case of postoperative residual infection.There was no postoperative bleeding,postoperative intestinal fistula,intestinal obstruction and other serious complications.The mean follow-up time was(29.8±15.8)months,and 1 case recurred in the follow-up period.Conclusion It is a safe and effective procedure to remove the infected mesh and close the wound and defect simultaneously.