The negative pressure wound therapy may salvage the infected mesh following open incisional hernia repair

Ventral Hernia Repair: Does Mesh Position Matter?

Mesh positioning is a commonly discussed detail in ventral hernia repair and is often cited as a major contributor to the outcome of the operation. However, there is a paucity of data that establishes one plane as superior to others. In this article, we will provide an overview of all potential planes to place prosthetic material and review the relevant literature supporting each option and the complications associated with accessing each anatomic plane.

Multicentre Cross-Sectional Study Describing Postoperative Wound Care Practice in Northeast Ethiopia

Background

Postoperative care is the management of a patient after surgery that includes care given during the immediate postoperative period. Postoperative complications are continuing to be a major source of morbidity following operative procedures. Postoperative wound infection delays the patient's recovery, increases discomfort, and prolongs the hospital stay.

Objective

The study aimed to assess among nurses working in governmental hospitals in the south Wollo zone and Oromia special zone, northeast Ethiopia, 2020.

Methods

Institution-based cross-sectional study design was conducted on governmental hospitals in the south Wollo zone and Oromia special zone. Variables in multivariable logistic regression, p-value < 0.05 was used to declare statistical significance.

Result

From a total of 411 samples, 402 nurses responded to the questionnaire, with a response rate of 97.81%. This study showed that 49.8% of participants had good practice. The availability of a wound management tool was 1.6 times more likely to promote good practice than the lack of a wound assessment tool. Nurses who had documented their wound assessment and management activities were 2.1 times more likely to have good practice than those who hadn't documented.

Conclusion

This study showed that half of the participants had poor wound care practices. Regarding associated factors, the availability of wound management tools and documentation of wound assessment and management had a significant association with the nurse's poor wound care practice. On the basis of these results, health policymakers and hospital administrators should develop a program to train nurses in wound care practice, and it helps as a reference for the researchers to further study.

A Ventral Hernia-repair-related Mycobacterium mageritense Mesh Infection Treated with NPWT without Mesh Removal

Abdominal hernias are often repaired using prosthetic mesh, which is susceptible to infections. Normally, it is necessary to remove the mesh. However, successful mesh salvation with negative-pressure wound therapy (NPWT) has recently been reported. We encountered Mycobacterium(M) mageritense infection after hernia repair using the mesh. M. mageritense is classified as a fast-growing nontuberculous mycobacterium, but few cases have been reported. Nontuberculous mycobacterium can cause rare chronic infections. Skin and soft-tissue infections by nontuberculous mycobacterium involving localized abscess formation and chronic abscesses under various situations have been reported. We report an 85-year-old woman in whom a ventral hernia repair-related M. mageritense mesh infection was treated with NPWT without mesh removal. The hernia was repaired using Bard Ventralex mesh. Pus discharge was seen on the seventh postoperative day, and there was a small area of necrosis under the mesh. From the 13th postoperative day, NPWT was performed for 4 weeks. On the 29th postoperative day, a M. mageritense infection was diagnosed, which was resistant to multiple drugs. After the NPWT, most of the wound showed good granulation tissue formation. In conclusion, the mesh used to repair a hernia became infected with M. mageritense, but NPWT was able to salvage it. In cases of mesh infection involving small necrotic areas, performing NPWT under the guidance of an infectious disease expert may make it possible to preserve the mesh.