临床外科杂志
臨床外科雜誌
림상외과잡지
JOURNAL OF CLINICAL SURGERY
2014年
9期
653-655
,共3页
疝%补片修补术%补片感染
疝%補片脩補術%補片感染
산%보편수보술%보편감염
hernia%mesh repair%mesh infectoin
目的：探讨疝修补术后补片感染的原因、预防及治疗方法。方法回顾性分析1997年12月至2013年12月我院收治的14例使用补片修补腹壁疝术后补片感染的临床资料。其中腹股沟疝平片修补1例，腹股沟疝腹膜前间隙修补11例，切口疝1例，使用巴德Composix补片开放式腹腔内补片修补；造口疝1例，腹壁肌肉前置入补片修补。根据感染程度、材料不同采用相应的治疗方法，4例去除补片，10例开放换药。结果全组患者均治愈出院，无围手术期死亡。手术过程中无大出血和膀胱损伤。随访时间8～64个月，1例切口疝术后复发。结论产生补片感染的原因很多，预防感染最为重要。一旦发生补片感染，治疗方法应个体化，有效引流及合理运用抗生素可解决多数聚丙烯（PPM）补片感染，唯膨体聚四氟乙烯（ePTFE）补片需完全去除。
目的：探討疝脩補術後補片感染的原因、預防及治療方法。方法迴顧性分析1997年12月至2013年12月我院收治的14例使用補片脩補腹壁疝術後補片感染的臨床資料。其中腹股溝疝平片脩補1例，腹股溝疝腹膜前間隙脩補11例，切口疝1例，使用巴德Composix補片開放式腹腔內補片脩補；造口疝1例，腹壁肌肉前置入補片脩補。根據感染程度、材料不同採用相應的治療方法，4例去除補片，10例開放換藥。結果全組患者均治愈齣院，無圍手術期死亡。手術過程中無大齣血和膀胱損傷。隨訪時間8～64箇月，1例切口疝術後複髮。結論產生補片感染的原因很多，預防感染最為重要。一旦髮生補片感染，治療方法應箇體化，有效引流及閤理運用抗生素可解決多數聚丙烯（PPM）補片感染，唯膨體聚四氟乙烯（ePTFE）補片需完全去除。
목적：탐토산수보술후보편감염적원인、예방급치료방법。방법회고성분석1997년12월지2013년12월아원수치적14례사용보편수보복벽산술후보편감염적림상자료。기중복고구산평편수보1례，복고구산복막전간극수보11례，절구산1례，사용파덕Composix보편개방식복강내보편수보；조구산1례，복벽기육전치입보편수보。근거감염정도、재료불동채용상응적치료방법，4례거제보편，10례개방환약。결과전조환자균치유출원，무위수술기사망。수술과정중무대출혈화방광손상。수방시간8～64개월，1례절구산술후복발。결론산생보편감염적원인흔다，예방감염최위중요。일단발생보편감염，치료방법응개체화，유효인류급합리운용항생소가해결다수취병희（PPM）보편감염，유팽체취사불을희（ePTFE）보편수완전거제。
Objective To evaluate the causes,prevention and treatment of mesh infection after abdominal wall hernia mesh repair.Methods The clinical data of 14 mesh infections admitted from De-cember 1997 to December 2013 were analyzed retrospectively.There were one case of inguinal hernia with Lichtenstein repair,eleven cases of inguinal hernia with preperitoneal repair,one case of incisional hernia with Bard Composix Mesh and 1 case of parastomal hernia with mesh repair above the abdominal muscle. Based on prothetic materials and infection status,the infection meshes were removed in 4 cases and open dressing change were operated in 10 cases.Results All patients were healed and discharged without peri-operative death.There was no hemorrhage and bladder injury during the procedures.The time of dressing change ranged from 3 weeks to 6 months,with a median of 4 weeks.All patients were followed up for 8 to 64 months.One patient had a recurrence of abdominal incisional hernia.Conclusion There are many fac-tors related to mesh infection after mesh repair and preventing mesh infection is the most important.Once the infection occurs,the management should be individualized.Antibiotic treatment and surgical drainage can be effective in most polypropylene mesh(PPM)infection However,infected expanded polytetrafluoro-ethylene(ePTFE)mesh should be removed completely.
