腹股沟疝补片修补术后补片感染外科处理方法的研究

目的探讨腹股沟疝补片修补术后补片感染的外科处理方法和经验。方法回顾性分析北京朝阳医院疝和腹壁外科2011年1月至2012年6月期间收治的67例腹股沟疝补片修补术后发生补片感染患者的临床资料，对患者的伤口愈合情况加以分析。结果67例患者均行清除感染补片及周围感染组织，未再重新放置补片，均行一期全层缝合伤口，同时放置伤口引流管。均成功清除了感染的补片；术后住院时间10～25d，平均16d；术后伤口一期愈合51例，拆线后伤口存在浅部感染、经局部换药后延期愈合16例。术后66例患者获访，随访时间为6～24个月（平均20个月）。随访期间，均无切口下积液、伤口感染、肠瘘、术后疼痛等并发症发生，无腹股沟疝复发。结论腹股沟疝补片修补术后补片感染的外科处理十分复杂，采用去除补片、彻底清创、一期缝合及放置伤口引流管的综合手术治疗方法可以获得比较满意的疗效。

Surgical Treatment for Mesh Infection after Prosthetic Patch Repair of Inguinal Hernia

Objective To discuss the surgical treatment and experience of mesh infection after prosthetic patch repair of inguinal hernia. Methods The clinical data of 67 cases of mesh infection after prosthetic patch repair who were treated in Chao-Yang Hospital from Jan. 2011 to Jun. 2012 were retrospectively analyzed. Results All patients were treated with surgical operation successfully, including removing the infected mesh and surrounding tissues, primary suture, and a placement of wound drainage, without replacement of a new patch substitute. The hospital stay of the patients was 10-25 days with an average of 16 days. Of the 67 patients, 51 patients got primary healed and the other 16 patients healed delayed after local dressing change due to the superficial infection following stitch removal. Sixty-six patients were followed-up for 6-24 months （average of 20 months） after operation without recurrence and complication, including seroma, wound infection, intestinal fistula, and postoperative pain. Conclusions The treatment of mesh infection after inguinal hernia repair is very complicated, hut the primary suture repair and a placement of wound drainage after removing infected mesh with complete debridement is a effective therapy for it.