Hello Dr. Chandrashekhar,
Thank you for your query regarding the management of mesh infections following recurrent incisional hernia repair.
General Management Approach
Assessment
- Evaluate the extent and severity of the infection using clinical examination, laboratory markers, and imaging if necessary.
- Differentiate between superficial and deep-seated infections.
Conservative Management
- For localized or superficial infections, initiate broad-spectrum antibiotics based on culture sensitivities.
- Consider percutaneous or surgical drainage if abscess formation is identified.
Mesh Removal
- In cases of deep or persistent infections, removal of the mesh may be necessary.
- Timing of explantation should be determined based on the patient’s clinical stability and response to conservative measures.
Adjunctive Therapies
- Negative Pressure Wound Therapy (NPWT) can be considered to promote wound healing and manage chronic infections.
- Optimize the patient’s nutritional and immunological status prior to any re-intervention.
Multidisciplinary Collaboration
- Engage with infectious disease specialists and consider a team approach to tailor the management plan according to the patient’s overall condition and specific infection characteristics.