Factors related to successful mesh salvage with negative pressure wound therapy: a retrospective cohort study.

IF 2.6 2区医学 Q1 SURGERY Hernia Pub Date : 2024-12-04 DOI:10.1007/s10029-024-03233-3

Alejandro González-Muñoz, Juan Carlos Vallejo-Soto, Juan Diego Barragán-Pinilla, Antonio Pesce, Camilo Ramírez-Giraldo

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Abstract

Background: Mesh salvage using negative pressure wound therapy (NPWT) in cases of mesh infection following hernia repair has emerged as an alternative to early mesh removal. However, the factors related to the success or failure of mesh salvage with NPWT remain unclear.

Methods: This retrospective cohort study included 61 patients with mesh infections after hernia repair treated with NPWT between 2018 and 2024. We analyzed demographic, clinical, and surgical variables, as well as the bacterial spectrum and antimicrobial susceptibility. A binary logistic regression model was used to identify factors associated with NPWT failure, defined as the need for mesh removal.

Results: Mesh salvage was successful in 80.3% of cases. Active smoking was significantly associated with NPWT failure (OR = 7.82, CI 95% 1.05-64.8; p = 0.044). Other factors, such as age, body mass index, Charlson comorbidity index, mesh type, and mesh position, were not significantly related to failure. Most infections were caused by Staphylococcus aureus (24.6%) and Escherichia coli (22.9%).

Conclusions: NPWT is an effective method for salvaging infected meshes, with a high success rate. Active smoking was identified as a risk factor for NPWT failure, highlighting the need for early identification of patients who may benefit from alternative approaches. Further studies are required to develop predictive models for NPWT success in mesh salvage.

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负压伤口治疗成功补片抢救的相关因素：一项回顾性队列研究。

背景：在疝修补后补片感染的情况下，使用负压伤口治疗（NPWT）补片抢救已成为早期补片取出的一种替代方法。然而，与NPWT补片抢救成功或失败相关的因素仍不清楚。方法：本回顾性队列研究纳入了2018年至2024年期间使用NPWT治疗疝修补术后补片感染的61例患者。我们分析了人口统计学、临床和手术变量，以及细菌谱和抗菌药物敏感性。使用二元逻辑回归模型来识别与NPWT失效相关的因素，定义为需要去除网格。结果：补片抢救成功率为80.3%。主动吸烟与NPWT失败显著相关(OR = 7.82, CI 95% 1.05-64.8；p = 0.044)。其他因素如年龄、体重指数、Charlson合并症指数、补片类型和补片位置与失败无显著相关。感染以金黄色葡萄球菌（24.6%）和大肠杆菌（22.9%）为主。结论：NPWT是一种有效的修复感染网片的方法，成功率高。积极吸烟被认为是NPWT失败的一个危险因素，这突出了早期识别可能从替代方法中获益的患者的必要性。需要进一步的研究来开发NPWT在补片打捞中成功的预测模型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.