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Published on: September 11, 2021
[Surgical treatment of postoperative infected hernias]
Abstract:
The article deals with the results of examination and treatment of 153 patients with postoperative ventral hernias. In 109 (71.3%) of these patients the hernia formed due to suppuration of the wound after the first operation; 48 (31.4%) hab on admission a source of purulent surgical infection in the zone of the future operative intervention. According to the findings of microbiological examination of intraoperative biopsies and smears taken from wounds and fistulas, the patients were divided into three groups (group 1, 10(1) microbial bodies per kg tissue; group 2, 10(2); group 3, 10(5)). Pharmacological studies showed that the necessary concentration of broad-spectrum antibiotics is produced only when they are injected by the infiltrative method. On basis of this, the authors developed a scheme for the prevention of purulent complications in herniotomy with the use of biological and synthetic prostheses for each group of patients. The method produced good results in the majority of patients with minimal suppurations (3.9%) and recurrent hernias (0.65%).
Insights
This study on postoperative ventral hernias found that infiltrative antibiotic delivery effectively prevents wound suppuration and recurrence. The developed prevention scheme significantly reduced complications in patients undergoing herniotomy.
Area of Science:
- Surgical Oncology
- Infectious Disease Management
- Biomaterials Science
Context:
- Postoperative ventral hernias are a significant complication, often linked to wound infections.
- A high incidence (71.3%) of hernias in the study cohort resulted from wound suppuration after initial surgery.
- Many patients (31.4%) presented with existing purulent surgical infections at the operative site.
Purpose:
- To investigate the efficacy of infiltrative antibiotic delivery for preventing purulent complications in herniotomy.
- To develop a group-specific prevention strategy for purulent complications using biological and synthetic prostheses.
- To evaluate the outcomes of a novel prevention scheme in patients with postoperative ventral hernias.
Summary:
- The study examined 153 patients with postoperative ventral hernias, categorizing them into three groups based on microbial load (10^1 to 10^5 CFU/kg).
- Pharmacological analysis confirmed that infiltrative antibiotic administration achieves optimal concentrations for broad-spectrum coverage.
- A tailored prevention scheme, incorporating infiltrative antibiotics and prostheses, was implemented for each patient group.
Impact:
- The developed method demonstrated excellent results, significantly minimizing suppurations (3.9%) and recurrent hernias (0.65%).
- This approach offers a promising strategy for reducing morbidity associated with ventral hernia repair.
- Highlights the importance of targeted antibiotic prophylaxis in managing complex surgical site infections.
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