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Published on: February 2, 2024
Localised fungal infection in a prosthetic mesh treated conservatively
Mehwash Nadeem1, Hasnain Zafar, Muhammad Shahrukh Effendi
1Department of Surgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan. drmehwash7@gmail.com
Abstract:
Infection remains one of the most challenging complications of mesh hernioplasty. The authors report a case of a 28-year-old male with no known comorbidities who underwent reversal of ileostomy and prolene mesh hernioplasty. His wound was left open for delayed primary closure, although daily dressing started from second postoperative day. He developed fungal infection of prolene mesh on fifth postoperative day which was successfully treated with irrigation and daily wound dressing with amphotericin B avoiding the complications associated with mesh excision. He made an uneventful recovery and on last follow-up his wound was granulating well with no signs of infection.
Insights
Fungal infection of prolene mesh after hernioplasty can be treated with amphotericin B irrigation and dressing. This approach successfully managed mesh infection, avoiding mesh removal and ensuring a full recovery.
Area of Science:
- Surgical complications
- Mycology in medicine
Background:
- Mesh hernioplasty is a common surgical procedure.
- Mesh infection is a significant complication, potentially requiring mesh removal.
- Fungal infections of surgical mesh are rare but challenging.
Observation:
- A 28-year-old male developed a fungal infection of prolene mesh five days after hernioplasty.
- The wound was managed with delayed primary closure and daily dressings.
- The patient had no prior comorbidities.
Findings:
- Successful treatment of fungal mesh infection with amphotericin B irrigation and daily wound dressing.
- Avoidance of mesh excision, a common complication management strategy.
- Uneventful recovery with well-granulating wound and no signs of infection at follow-up.
Implications:
- Amphotericin B irrigation and dressing is a viable conservative treatment for fungal mesh infections.
- Preserving the mesh may lead to better patient outcomes and avoid further surgical procedures.
- Highlights the importance of vigilant wound monitoring and tailored treatment for surgical site infections.
