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Post recurrent inciscional hernia repair mesh infections ..line of management

D
Dr Chandrasekhar
Posted Under Others, on 5 February 2025

D
Dr Chandrasekhar
Posted Under Others, on 5 February 2025
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D
Dr. Bhavya GuptaExpert

Hello Dr. Chandrashekhar,

Thank you for your query regarding the management of mesh infections following recurrent incisional hernia repair.

General Management Approach

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.
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