Vacuum sealing drainage in the treatment of mesh infection following inguinal hernia repair_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Zhang ,  WU Yuquan

Department of Surgery, Huguosi Hospital of Beijing University of Chinese Medicine, Beijing 100035, P.R.China;

Corresponding?author：

WU Yuquan, Email: wyq20020426@vip.qq.com

Keywords：

inguinal hernia; mesh infection; vacuum sealing drainage; curative effect

DOI：

10.7507/1007-9424.201607081

Video：

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Objective To observe the clinical effect of vacuum sealing drainage (VSD) in the treatment of mesh infection following inguinal hernia repair. Methods A total of 24 patients who suffered form mesh infection following inguinal hernia repair and got treatment in our hospital from February 2012 to December 2015 were collected and divided into 2 groups according to the type of treatment, 12 patients (13 sides) of VSD group received treatment of VSD, and 12 patients (13 sides) of conventional group received conventional treatment. Comparison between the 2 groups in mesh retention rate, the wound healing time, hospitalization cost, and hospital stay was performed. Results There was significant difference in mesh retention rate〔76.9% (10/13)vs. 30.8% (4/13)〕, the wound healing time〔(20.5±4.4) dvs. (29.7± 6.7) d〕, hospitalization cost〔(18 430.1±7 180.2) RMBvs. (12 201.1±6 453.2) RMB〕, and hospital stay〔(23.5±4.1) dvs. (30.7±6.5) d〕between the VSD group and conventional group (P<0.050). Compared with conventional group, the mesh retention rate and hospitalization cost were higher, the wound healing time and hospital stay were shorter in VSD group. Conclusions VSD can effectively control the mesh infection following hernia repair, improve the mesh retention rate. The VSD can also promote growth of granulation tissue in cavity, shorten the wound healing time and hospital stay, but has a high hospitalization cost than conventional treatment.

Citation： WU Zhang, WU Yuquan. Vacuum sealing drainage in the treatment of mesh infection following inguinal hernia repair. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(3): 361-365. doi: 10.7507/1007-9424.201607081 Copy

1.	?方斌, 楊福全. 腹壁疝修補材料學研究進展. 中國實用外科雜志, 2015, 35(11): 1247-1250.
2.	中華醫學會外科學分會疝和腹壁外科學組, 中國醫師協會外科醫師分會疝和腹壁外科醫師委員會. 成人腹股溝疝診療指南(2014 年版). 中華疝和腹壁外科雜志(電子版), 2014, 8(3): 204-206.
3.	顧巖. 腹壁疝人工合成補片植入所致感染的防治. 外科理論與實踐, 2010, 15(6): 586-589.
4.	李光學, 高銳星, 李尚俊, 等. 腹股溝疝無張力修補術后補片感染的臨床分析. 中華疝和腹壁外科雜志: 電子版, 2016, 10(1): 66-67.
5.	Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery. Clin Microbiol Infect, 2005, 11(1): 3-8.
6.	Korenkov M, Sauerland S, Arndt M,et al. Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia. Br J Surg, 2002, 89(1): 50-56.
7.	陳杰. 重視腹外疝修補術后并發癥的防治. 中國普外基礎與臨床雜志, 2013, 20(12): 1329-1332.
8.	Jacobs S, Simhaee DA, Marsano A,et al. Efficacy and mechanisms of vacuum-assisted closure (VAC) therapy in promoting wound healing: a rodent model. J Plast Reconstr Aesthet Surg, 2009, 62(10): 1331-1338.
9.	Fleischmann W, Strecker W, Bombelli M,et al. Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg, 1993, 96(9): 488-492.
10.	Morykwas MJ, Argenta LC, Shelton-Brown EI,et al. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg, 1997, 38(6): 553-562.
11.	中華人民共和國衛生部. 醫院感染診斷標準(試行). 中華醫學雜志, 2001, 81(5): 314-320.
12.	潘麗杰, 高春江, 周文莉. 切口疝補片修補感染的危險因素分析. 中華醫院感染學雜志, 2015, 25(6): 1367-1371.
13.	楊先智. 腹股溝疝無張力修補術后切口感染的治療. 中華醫院感染學雜志, 2013, 23(12): 2881-2882.
14.	胡星辰, 唐健雄. 材料學的最新進展對疝修補的影響. 國際外科學雜志, 2015, 42(9): 577-579.
15.	陳思夢, 劉力嘉. 腹股溝疝術后感染及慢性疼痛臨床處理. 中國實用外科雜志, 2014, 34(5): 398-400.
16.	時德, 趙渝. 疝修補材料特征與新概念. 中華疝和腹壁外科雜志(電子版), 2012, 6(1): 517-520.
17.	王小強, 李小軍. 補片感染的診斷和處理原則. 中國實用外科雜志, 2008, 28(12): 1022-1024.
18.	楊林華, 陳濤, 王堅. 腹股溝嵌頓疝術后手術部位感染因素分析. 中國實用外科雜志, 2012, 32(12): 1043-1045.
19.	孫立, 申英末, 陳杰, 等. 腹股溝疝補片修補術后補片感染外科處理方法的研究. 中國普外基礎與臨床雜志, 2013, 20(12): 1341-1343.
20.	Plikaitis CM, Molnar JA. Subatmospheric pressure wound therapy and the vacuum-assisted closure device: basic science and current clinical successes. Expert Rev Med Device, 2006, 3(2): 175-184.
21.	裘華德, 宋九宏. 負壓封閉引流技術. 北京: 人民衛生出版社, 2010: 5-6.
22.	吳堅, 羅興良, 馬樹云, 等. 下肢骨折創面感染患者負壓封閉引流治療對下肢微循環及愈合的影響分析. 中華醫院感染學雜志, 2016, 26(17): 3978-3980.
23.	余洪濤. VSD負壓封閉引流技術在腹外疝修補術后早期切口感染中臨床應用. 中華疝和腹壁外科雜志(電子版), 2015, 9(4): 337-339.
24.	宗振, 江志鵬, 侯澤輝, 等. 自制負壓封閉引流裝置治療腹股溝疝術后補片感染療效分析. 中國實用外科雜志, 2016, 36(5): 569-570.
25.	任群洲, 王曉明. 改良全封閉式持續負壓術(VSD)在治療中的應用. 中國社區醫師(醫學專業), 2010, (16): 74-75.
26.	Kenji N, Ihama Y, Fukasawa M,et al. Morphologic investigation of injury caused by locally applied negative pressure in a rat model. Leg Med (Tokyo), 2012, 14(1): 21-26.
27.	張玉, 崔恒心, 田娜, 等. VSD技術在肢體創面應用中并發癥發生的原因分析及護理對策. 中國醫療前沿, 2011, 6(17): 69-70.

1. ?方斌, 楊福全. 腹壁疝修補材料學研究進展. 中國實用外科雜志, 2015, 35(11): 1247-1250.
2. 中華醫學會外科學分會疝和腹壁外科學組, 中國醫師協會外科醫師分會疝和腹壁外科醫師委員會. 成人腹股溝疝診療指南(2014 年版). 中華疝和腹壁外科雜志(電子版), 2014, 8(3): 204-206.
3. 顧巖. 腹壁疝人工合成補片植入所致感染的防治. 外科理論與實踐, 2010, 15(6): 586-589.
4. 李光學, 高銳星, 李尚俊, 等. 腹股溝疝無張力修補術后補片感染的臨床分析. 中華疝和腹壁外科雜志: 電子版, 2016, 10(1): 66-67.
5. Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery. Clin Microbiol Infect, 2005, 11(1): 3-8.
6. Korenkov M, Sauerland S, Arndt M,et al. Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia. Br J Surg, 2002, 89(1): 50-56.
7. 陳杰. 重視腹外疝修補術后并發癥的防治. 中國普外基礎與臨床雜志, 2013, 20(12): 1329-1332.
8. Jacobs S, Simhaee DA, Marsano A,et al. Efficacy and mechanisms of vacuum-assisted closure (VAC) therapy in promoting wound healing: a rodent model. J Plast Reconstr Aesthet Surg, 2009, 62(10): 1331-1338.
9. Fleischmann W, Strecker W, Bombelli M,et al. Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg, 1993, 96(9): 488-492.
10. Morykwas MJ, Argenta LC, Shelton-Brown EI,et al. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg, 1997, 38(6): 553-562.
11. 中華人民共和國衛生部. 醫院感染診斷標準(試行). 中華醫學雜志, 2001, 81(5): 314-320.
12. 潘麗杰, 高春江, 周文莉. 切口疝補片修補感染的危險因素分析. 中華醫院感染學雜志, 2015, 25(6): 1367-1371.
13. 楊先智. 腹股溝疝無張力修補術后切口感染的治療. 中華醫院感染學雜志, 2013, 23(12): 2881-2882.
14. 胡星辰, 唐健雄. 材料學的最新進展對疝修補的影響. 國際外科學雜志, 2015, 42(9): 577-579.
15. 陳思夢, 劉力嘉. 腹股溝疝術后感染及慢性疼痛臨床處理. 中國實用外科雜志, 2014, 34(5): 398-400.
16. 時德, 趙渝. 疝修補材料特征與新概念. 中華疝和腹壁外科雜志(電子版), 2012, 6(1): 517-520.
17. 王小強, 李小軍. 補片感染的診斷和處理原則. 中國實用外科雜志, 2008, 28(12): 1022-1024.
18. 楊林華, 陳濤, 王堅. 腹股溝嵌頓疝術后手術部位感染因素分析. 中國實用外科雜志, 2012, 32(12): 1043-1045.
19. 孫立, 申英末, 陳杰, 等. 腹股溝疝補片修補術后補片感染外科處理方法的研究. 中國普外基礎與臨床雜志, 2013, 20(12): 1341-1343.
20. Plikaitis CM, Molnar JA. Subatmospheric pressure wound therapy and the vacuum-assisted closure device: basic science and current clinical successes. Expert Rev Med Device, 2006, 3(2): 175-184.
21. 裘華德, 宋九宏. 負壓封閉引流技術. 北京: 人民衛生出版社, 2010: 5-6.
22. 吳堅, 羅興良, 馬樹云, 等. 下肢骨折創面感染患者負壓封閉引流治療對下肢微循環及愈合的影響分析. 中華醫院感染學雜志, 2016, 26(17): 3978-3980.
23. 余洪濤. VSD負壓封閉引流技術在腹外疝修補術后早期切口感染中臨床應用. 中華疝和腹壁外科雜志(電子版), 2015, 9(4): 337-339.
24. 宗振, 江志鵬, 侯澤輝, 等. 自制負壓封閉引流裝置治療腹股溝疝術后補片感染療效分析. 中國實用外科雜志, 2016, 36(5): 569-570.
25. 任群洲, 王曉明. 改良全封閉式持續負壓術(VSD)在治療中的應用. 中國社區醫師(醫學專業), 2010, (16): 74-75.
26. Kenji N, Ihama Y, Fukasawa M,et al. Morphologic investigation of injury caused by locally applied negative pressure in a rat model. Leg Med (Tokyo), 2012, 14(1): 21-26.
27. 張玉, 崔恒心, 田娜, 等. VSD技術在肢體創面應用中并發癥發生的原因分析及護理對策. 中國醫療前沿, 2011, 6(17): 69-70.

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