Role of Vacuum-Assisted Closure Therapy in the Management of Exposed Mesh after Ventral Hernia Repair | ||||
| International Journal of Medical Arts | ||||
| Article 19, Volume 4, Issue 1, January 2022, Page 2082-2087 PDF (1.29 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2022.109196.1403 | ||||
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| Author | ||||
Mahmoud Elsayed Nagaty  
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| Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Mesh-related infection after open ventral hernia repair is a clinical dilemma in abdominal wall hernia surgery, especially in the bacterial resistance era. The management of such a problem usually needs complete mesh excision, which results in a high recurrence rate. Objective: The goals of the current study were to evaluate the efficacy of negative pressure wound therapy [NPWT] in infected mesh preservation. Patients and Methods: This prospective study was carried out from January 2017 to December 2019. A total of twenty-four cases with mesh exposure after ventral hernia repair was involved in our study. Patients were categorized into two comparable groups, Group I: VAC was applied for the preservation of the infected mesh, Group II: conventional wound care dressing was used. Patients’ demographics, types of hernia, wound diameter, and the outcomes of each technique were recorded in the study. Results: Out of 24 patients there were 9 males and 15 females, the mean age was 42 years. Types of hernias were 15 paraumbilical hernias, 6 incisional hernias, and 3 recurrent hernias. The wound size in group I ranged from18 x 11 cm – 8.5 x 5 cm and in group II ranged from 16.5 x10 cm – 7 x 5. In Group I, the mesh salvage was accomplished in 11 cases [91.7%] and the wound closed with 2ndary suturing and only 1 [8.3%] patient need partial mesh excision. While In Group II, mesh salvage was accomplished in 5 cases [41.7%] however, 7 [58.3%] patients needed radical en-bloc mesh excision. All the cases had followed up for 6 months. Conclusion: NPWT/VAC therapy has excellent and promising outcomes in the preservation of infected prosthesis. | ||||
| Keywords | ||||
| Ventral hernia repair; Infected mesh; Vacuum-assisted closure | ||||
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