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Negative Pressure Wound Therapy for Treatment of Mesh Infection After Abdominal Surgery : Long-Term Results and Patient-Reported Outcome

Nobaek, S.; Rogmark, P. LU and Petersson, U. LU (2017) In Scandinavian Journal of Surgery 106(4). p.285-293
Abstract

Background and Aims: Treatment of synthetic mesh infections has previously often resulted in mesh explantation. Negative pressure wound therapy has been used in these situations with encouraging results. The aims of this study were to evaluate wound healing, mesh preservation, and patient-reported outcome after negative pressure wound therapy of mesh infections. Material and Methods: Medical records of patients treated with negative pressure wound therapy for mesh infection and age-matched mesh-operated controls without postoperative complications were scrutinized in a retrospective study. An abdominal wall complaints questionnaire was used to evaluate patient-reported outcome. Results: Of 722 mesh operations performed 2005–2012,... (More)

Background and Aims: Treatment of synthetic mesh infections has previously often resulted in mesh explantation. Negative pressure wound therapy has been used in these situations with encouraging results. The aims of this study were to evaluate wound healing, mesh preservation, and patient-reported outcome after negative pressure wound therapy of mesh infections. Material and Methods: Medical records of patients treated with negative pressure wound therapy for mesh infection and age-matched mesh-operated controls without postoperative complications were scrutinized in a retrospective study. An abdominal wall complaints questionnaire was used to evaluate patient-reported outcome. Results: Of 722 mesh operations performed 2005–2012, negative pressure wound therapy was used for treating postoperative mesh infections in 48 patients. A total of 48 age-matched controls were recruited from patients without wound complications. No differences were found between groups regarding preoperative characteristics. The following peroperative characteristics were significantly more frequent in the negative pressure wound therapy group: emergency operation, dirty/infected surgical field, surgical techniques other than laparoscopic intraperitoneal onlay mesh repair, implantation of more than one mesh, larger mesh size, longer duration of surgery, and mesh not completely covered with anterior rectus fascia. The entire mesh was salvaged in 92%, while four meshes were partly excised. Wounds healed in 88% after a median of 110 (range 3–649) days. In total, 85% in the negative pressure wound therapy group and 75% in the control group answered the questionnaire. There were no significant differences regarding pain, other abdominal wall symptoms, and satisfaction with the final result in favor of the controls. Conclusion: No mesh had to be explanted and wound healing was achieved in the majority of patients when negative pressure wound therapy was used for treatment of mesh infections. However, time to healing was long, and numerous procedures were sometimes needed. Positive long-term outcome was more frequently reported among controls.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal surgery, incisional hernia, infection, mesh, negative pressure wound therapy, patient-reported outcome
in
Scandinavian Journal of Surgery
volume
106
issue
4
pages
9 pages
publisher
Finnish Surgical Society
external identifiers
  • scopus:85035060826
  • wos:000416023000001
ISSN
1457-4969
DOI
10.1177/1457496917690966
language
English
LU publication?
yes
id
7b56b255-dbd7-4f59-877f-1460a3aa760f
date added to LUP
2017-12-12 07:23:41
date last changed
2018-01-16 13:27:30
@article{7b56b255-dbd7-4f59-877f-1460a3aa760f,
  abstract     = {<p>Background and Aims: Treatment of synthetic mesh infections has previously often resulted in mesh explantation. Negative pressure wound therapy has been used in these situations with encouraging results. The aims of this study were to evaluate wound healing, mesh preservation, and patient-reported outcome after negative pressure wound therapy of mesh infections. Material and Methods: Medical records of patients treated with negative pressure wound therapy for mesh infection and age-matched mesh-operated controls without postoperative complications were scrutinized in a retrospective study. An abdominal wall complaints questionnaire was used to evaluate patient-reported outcome. Results: Of 722 mesh operations performed 2005–2012, negative pressure wound therapy was used for treating postoperative mesh infections in 48 patients. A total of 48 age-matched controls were recruited from patients without wound complications. No differences were found between groups regarding preoperative characteristics. The following peroperative characteristics were significantly more frequent in the negative pressure wound therapy group: emergency operation, dirty/infected surgical field, surgical techniques other than laparoscopic intraperitoneal onlay mesh repair, implantation of more than one mesh, larger mesh size, longer duration of surgery, and mesh not completely covered with anterior rectus fascia. The entire mesh was salvaged in 92%, while four meshes were partly excised. Wounds healed in 88% after a median of 110 (range 3–649) days. In total, 85% in the negative pressure wound therapy group and 75% in the control group answered the questionnaire. There were no significant differences regarding pain, other abdominal wall symptoms, and satisfaction with the final result in favor of the controls. Conclusion: No mesh had to be explanted and wound healing was achieved in the majority of patients when negative pressure wound therapy was used for treatment of mesh infections. However, time to healing was long, and numerous procedures were sometimes needed. Positive long-term outcome was more frequently reported among controls.</p>},
  author       = {Nobaek, S. and Rogmark, P. and Petersson, U.},
  issn         = {1457-4969},
  keyword      = {Abdominal surgery,incisional hernia,infection,mesh,negative pressure wound therapy,patient-reported outcome},
  language     = {eng},
  month        = {12},
  number       = {4},
  pages        = {285--293},
  publisher    = {Finnish Surgical Society},
  series       = {Scandinavian Journal of Surgery},
  title        = {Negative Pressure Wound Therapy for Treatment of Mesh Infection After Abdominal Surgery : Long-Term Results and Patient-Reported Outcome},
  url          = {http://dx.doi.org/10.1177/1457496917690966},
  volume       = {106},
  year         = {2017},
}