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Successful photodynamic therapy for infectious complications of abdominoplasty using mesh implants: a case report
Ivan Vinokurov1, Evgeny Khaydukov1,2, Gela Lev1
1Scientific and Clinical Center No. 3, Petrovsky National Research Centre of Surgery, Moscow, Russia.
Introduction:
Infectious complications of abdominoplasty with mesh implants often require implant removal. Here, we demonstrate for the first time the unique capabilities of photodynamic therapy (PDT) for the treatment of a purulent complication of abdominoplasty with a mesh implant.
Case Presentation:
We report a 44-year-old female patient who underwent reconstruction of a chest wall defect with a transverse rectus abdominis myocutaneous flap and abdominoplasty of the abdominal wall with a mesh implant after treatment for a recurrent deep sternal infection. The postoperative period was complicated by postoperative wound suppuration with implant protrusion. Wound drainage, negative pressure wound therapy and antibacterial therapy were ineffective. The patient was included in a clinical trial on the use of PDT for wound treatment. Five PDT sessions were performed. A riboflavin mononucleotide solution was used as a photosensitizer, which was irrigated on the wound, and after a 2-min pause, the PDT session began. A light source with a wavelength of 450 nm and a power of 0.1 W/cm2 was used for irradiation. The session was carried out until the energy reached 15 J/cm2. On the fifth day, the wound was completely cleaned and sutured with secondary sutures. It healed without any peculiarities. During the control examination after 10 months, no recurrence of the implant infection was observed.
Conclusion:
These results demonstrate the possibility of using the PDT method for the treatment of infected wounds with mesh implants, which is especially important in the context of increasing the antibiotic resistance of pathogenic strains of microorganisms.
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