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01-08-2012 | Case Report

Salvage of an infected titanium mesh in a large incisional ventral hernia using medicinal honey and vacuum-assisted closure: a case report and literature review

Authors: G. Chatzoulis, K. Chatzoulis, P. Spyridopoulos, P. Pappas, A. Ploumis

Published in: Hernia | Issue 4/2012

Abstract

The overall reported percentage of mesh infections is 1.3%. Infections after incisional ventral hernia repair depend on many factors. Salvaging an infected mesh should be the priority, because serious complications are reported following mesh removal. In this case report, a methicillin-resistant Staphylococcus aureus (MRSA)-infected titanium mesh was salvaged by a novel technique, not requiring removal. The combination of vacuum-assisted closure (VAC™ therapy) of the wound and medical honey (L-Mesitran™) proved to be successful in leaving the mesh in situ. We report the successful management of this infected titanium mesh and review the literature regarding the possible pathogenetic mechanisms and treatment options.

Aufenacker TJ, Koelemay MJ, Gouma DJ, Simons MP (2006) Systematic review and meta-analysis of the effectiveness of antibiotic prophylaxis in prevention of wound infection after mesh repair of abdominal wall hernia. Br J Surg 93(1):5–10PubMedCrossRef

Bringman S, Conze J, Cuccurullo D, Deprest J, Junge K, Klosterhalfen B et al (2010) Hernia repair: the search for ideal meshes. Hernia 14:81–87PubMedCrossRef

Stremitzer S, Bachleitner-Hofmann T, Gradl B, Gruenbeck M, Bachleitner-Hofmann B, Mittlboeck M et al (2010) 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 34:1702–1709PubMedCrossRef

Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV et al (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24:95–101PubMedCrossRef

Szczerba SR, Dumanian GA (2003) Definitive surgical treatment of infected or exposed ventral hernia mesh. Ann Surg 237(3):437–441PubMed

Itani KM, Hur K, Kim LT, Anthony T, Berger DH, Reda D et al (2010) Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg 145(4):322–328PubMedCrossRef

Schreinemacher MH, Emans PJ, Gijbels MJ, Greve JW, Beets GL, Bouvy ND (2009) Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model. Br J Surg 96(3):305–313PubMedCrossRef

Leber GE, Garb JL, Alexander AI, Reed WP (1998) Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 133(4):378–382PubMedCrossRef

Klinge U, Junge K, Spellerberg B, Piroth C, Klosterhalfen B, Schumpelick V (2002) Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface, the bacteria adherence, and the in vivo consequences in a rat model. J Biomed Mater Res 63(6):765–771PubMedCrossRef

10.

Bellón JM, G-Honduvilla N, Jurado F, G-Carranza A, Buján J (2001) In vitro interaction of bacteria with polypropylene/ePTFE prostheses. Biomaterials 22(14):2021–2024PubMedCrossRef

11.

Bachman S, Ramshaw B (2008) Prosthetic material in ventral hernia repair: how do I choose? Surg Clin North Am 88(1):101–112PubMedCrossRef

12.

Junge K, Rosch R, Klinge U, Saklak M, Klosterhalfen B, Peiper C et al (2005) Titanium coating of a polypropylene mesh for hernia repair: effect on biocompatibility. Hernia 9(2):115–119PubMedCrossRef

13.

Carbonell AM, Matthews BD, Dréau D, Foster M, Austin CE, Kercher KW et al (2005) The susceptibility of prosthetic biomaterials to infection. Surg Endosc 19(3):430–435PubMedCrossRef

14.

Parra JA, Revuelta S, Gallego T, Bueno J, Berrio JI, Fariñas MC (2004) Prosthetic mesh used for inguinal and ventral hernia repair: normal appearance and complications in ultrasound and CT. Br J Radiol 77:261–265PubMedCrossRef

15.

Boele van Hensbroek P, Wind J, Dijkgraaf MG, Busch OR, Carel Goslings J (2009) Temporary closure of the open abdomen: a systematic review on delayed primary fascial closure in patients with an open abdomen. World J Surg 33(2):199–207PubMedCrossRef

16.

Leininger BE, Rasmussen TE, Smith DL, Jenkins DH, Coppola C (2006) Experience with wound VAC and delayed primary closure of contaminated soft tissue injuries in Iraq. J Trauma 61(5):1207–1211PubMedCrossRef

17.

Gregor S, Maegele M, Sauerland S, Krahn JF, Peinemann F, Lange S (2008) Negative pressure wound therapy: a vacuum of evidence? Arch Surg 143(2):189–196PubMedCrossRef

18.

Braakenburg A, Obdeijn MC, Feitz R, van Rooij IA, van Griethuysen AJ, Klinkenbijl JH (2006) The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial. Plast Reconstr Surg 118(2):390–397PubMedCrossRef

19.

Tolino MJ, Tripoloni DE, Ratto R, García MI (2009) Infections associated with prosthetic repairs of abdominal wall hernias: pathology, management and results. Hernia 13:631–637PubMedCrossRef

20.

Postmes T, van den Bogaard AE, Hazen M (1993) Honey for wounds, ulcers, and skin graft preservation. Lancet 341(8847):756–757PubMedCrossRef

21.

Du Toit DF, Page BJ (2009) An in vitro evaluation of the cell toxicity of honey and silver dressings. J Wound Care 18(9):383–389PubMed

22.

Postmes T, Vandeputte J (1999) Recombinant growth factors or honey? Burns 25(7):676–678PubMed

23.

Rosengren H, Dixon A (2010) Antibacterial prophylaxis in dermatologic surgery: an evidence-based review. Am J Clin Dermatol 11(1):35–44PubMedCrossRef

24.

French VM, Cooper RA, Molan PC (2005) The antibacterial activity of honey against coagulase-negative staphylococci. J Antimicrob Chemother 56:228–231PubMedCrossRef

25.

Cooper RA, Jenkins L (2009) A comparison between medical grade honey and table honeys in relation to antimicrobial efficacy. Wounds 21(2):29–36

26.

Katsikogianni M, Missirlis YF (2004) Concise review of mechanisms of bacterial adhesion to biomaterials and of techniques used in estimating bacteria–material interactions. Eur Cell Mater 8:37–57PubMed

27.

Coda A, Botto Micca F, Bossotti M, Manfredi S, Mattio M, Ramellini G et al (1998) Reoperations for chronic infections following prosthetic hernia repair. Hernia 2(4):163–167CrossRef

Title: Salvage of an infected titanium mesh in a large incisional ventral hernia using medicinal honey and vacuum-assisted closure: a case report and literature review
Authors: G. Chatzoulis
K. Chatzoulis
P. Spyridopoulos
P. Pappas
A. Ploumis
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: Hernia / Issue 4/2012
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-010-0767-8

At a glance: The ONWARDS insulin icodec trials

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Salvage of an infected titanium mesh in a large incisional ventral hernia using medicinal honey and vacuum-assisted closure: a case report and literature review

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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