Abstract
Purpose: To evaluate the relation of incisional surgical site infection developed after operations for incisional hernias with malignancy, opening of intestines, status of the operations as urgent or elective and use of prosthetic materials and drains.
Patients and Methods: Patients operated for incisional hernia during the last 3 years are included in the study. Age, sex, status of the operations as urgent or elective, size of the hernia defect, type of the repair, usage and number of drains, presence of malignancy, opening of gastrointestinal tract, type of the mesh used, development of wound infection and microorganisms grown in the wound are all searched.
Results: Wound infection occurred in 18 of the 62 cases operated. Infection was reported in 14 of the 15 cases with bowel injury, 10 of the 14 cases with malignancy and 9 of the 12 cases operated on emergency. In 9 cases in which a single drain was used no infection was observed whereas infection developed in 18 out of 53 cases with two or more drains.
Conclusion: In this study opening of the bowel, presence of malignancy and operations on emergency were found as important risk factors for the development of wound infection with incisional hernia management.
Keywords:
Incisional hernia, wound infection, malignancy, emergency
References
1Jezupors A, Mihelsons M. The analysis of infection after polyprolene mesh repair of abdominal wall hernia. World J Surg 2006;30: 2270-2278.
2Dunn DL, Beilman GJ. Surgical infections. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE (eds). Schwartz's principles of surgery, 8th ed. New York: The McGraw- Hill Companies, 2005: 109-127.
3Rios A, Rodriguez JM, Munitiz V, Alcaraz P, Perez Flores D, Parrilla P. Antibiotic prophylaxis in incisional hernia repair using a prosthesis. Hernia 2001; 5: 148-152.
4Israelsson LA, Smedberg S, Montgomery A, Nordin P, Spangen L. Incisional hernia repair in Sweden 2002. Hernia 2006;10: 258-261.
5Houck JP, Rypins EB, Sarfeh IJ, Juler GL, Shimoda KJ. Repair of incisional hernia. Surg Gynecol Obstet 1989; 169: 397-399.
6Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J. Meta-analysisi of techniques for closure of midline abdominal incisions. Br J Surg 2002;89: 1350-1359.
7Sugerman HJ, Kellum JM Jr, Reines HD, DeMaria EJ, Newsome HH, Lowry JW. Greater risk of incisional hernia with morbidtly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 1996;171: 80-84.
8Korenkov M, Paul A, Sauerland S, Neugebauer E, Arndt M, Chevrel JP, Corcione F, Fingerhut A, Flament JB, Kux M, Matzinger A, Myrvold HE, Rath AM, Simmermacher RK. Clasissification and surgical treatment of incisional hernia. Resulte of an experts' meeting. Langenbecks Arch Surg 2001;386: 65-73.
9Davis JM, Wolff B, Cunningham TF, Drusin L, Dineen P. Delayed wound infection. An 11-year survey. Arch Surg 1982;117: 113-117.
10Post S, Weiss B, Willer M, Neufang T, Lorenz D. Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 2004;91: 44-48.
11Burger JW, Luijendik R, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long Term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 2004; 240: 578- 585.
12Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg 2002;98: 534- 545.
13Flum DR, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 2003;237: 129-135.
14Amid PK, Shulman AG, Lichtenstein IL, Hakakha M. Biomaterials for abdominal wall hernia surgery and principles of their applications. Langenbecks Arch Chir 1994;379: 168-171.
15Demirer S, Gecim IE, Aydinuraz K,Ataoğlu H, Yerdel MA, Kuterdem E. Affinity of Staphylococcus epidermidis to various prosthetic graft materials. J Surg Res 2001; 99:70-74.
16Nichols RL. Surgical wound infection. Am J Med 1991; 91: 54-64.
17White TJ, Santos MC, Thompson JS. Factors affecting wound complications in repair of ventral hernias. Am Surg 1998;64: 276-280.
18Mueller CB. Editorial: Abdominal incisional hernia--the role of wound infection. Can J Surg 1974;17: 195.
19Von Smitten K, Heikel HV, Sundell B. Repair of incisional hernias by F. Langenskiold's operation. Acta Chir Scand 1982;148: 257-261.
