Q: 62 years old female is admitted to ICU with septic shock. Patient was found to have a mesh infection with her previous ventral wall hernia repair. Name few risk factors for infections after hernia repair?
Answer: Hernia repair is usually an uncomplicated surgery. At the same time, there is a long list of risk factors for its complications. The objective of this question is to mention some of the risk factors:
- Old age
- Obesity
- Low serum albumin
- Diabetes
- Smoking
- Immunosuppression
- Chronic steroid use
- CHF
- Underlying COPD
- ASA score >3
- History of MRSA infection
- Emergency procedure
- Prolonged operative time
- Enterotomy or bowel resection done during repair
- Perioperative blood transfusion
- Use of mesh to repair large ventral hernia defects >10 cm
#surgical-critical-care
References:
1. Finan KR, Vick CC, Kiefe CI, et al. Predictors of wound infection in ventral hernia repair. Am J Surg 2005; 190:676.
2. Mavros MN, Athanasiou S, Alexiou VG, et al. Risk factors for mesh-related infections after hernia repair surgery: a meta-analysis of cohort studies. World J Surg 2011; 35:2389.
3. Stremitzer S, Bachleitner-Hofmann T, Gradl B, et al. Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations. World J Surg 2010; 34:1702.
4. Ousley J, Baucom RB, Stewart MK, et al. Previous Methicillin-Resistant Staphylococcus aureus Infection Independent of Body Site Increases Odds of Surgical Site Infection after Ventral Hernia Repair. J Am Coll Surg 2015; 221:470.
No comments:
Post a Comment