| 摘要 |
In recent years, tension-free technique has opened a new era in hernia surgery. Late deep prosthetic infection following a mesh repair of inguinal hernia has rarely been reported in the literature. This report presents four cases of late infection (two patients operated on at our hospital, two patients undergoing herniorraphy at another hospital) treated in a 24-month period (1997 through 1998) by the Surgery Department, Hsin-Chu Hospital, Department of Health, the Executive Yuan. We have performed Lichtenstein's tension-free hernioplasty with Marlex mesh since 1996. One hundred eight-five mesh repairs were done in a 3-year period. Two cases were complicated with late infections, and the infection rate was 1.08%. The median interval between repair and the infection rate was 1.08%. The mediian interval between repair and the presentation of late infection was 6 months (ranging from 3 to 11 months). The infection rate for traditional herniorraphy was 0.5%. Increased operating time and the use of resterilized mesh may have contributed to our high infection rate. Conventional therapy had no effect on the control of these infections. The usual infecting organism is Staphylococcus aureus. We conclude that delayed mesh infection is a serious complication following a mesh repair of inguinal hernia. The only way to cure the late infection is to remove the implanted mesh. An important measure for reducing the chance of prosthetic infection is to observe aseptic practices during mesh preparation and implantation. |
