International Surgery Journal | April-June 2016 | Vol 3 | Issue 2 Page 950 International Surgery Journal Vagholkar K et al. Int Surg J. 2016 May;3(2):950-953 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Case Report Hernia mesh infection: a surgical disaster Ketan Vagholkar*, Amish Pawanarkar, Suvarna Vagholkar, Madhavan Iyengar, Shamshershah Pathan INTRODUCTION Within the last few years the use of mesh for repair of various types of hernia has become a standard practice. 1 The incidence of recurrence has gone down significantly making this a gold standard for hernia repair. 2,3 However in the event of infection developing a series of catastrophic events ranging from localized swelling and redness to severe sepsis with fistula formation can develop. 1,3 Identifying the various factors which may predispose to infection can prevent such septic calamities. 4 A case of laparoscopic mesh infection treated by a two staged surgical procedure is presented with a review of literature. CASE REPORT A 34 year old male patient was referred to our surgical facility for management of severe mesh infection following a laparoscopic repair for an upper abdominal ventral hernia. The patient gave a history of having undergone a laparoscopic mesh repair for an upper abdominal ventral hernia. Two weeks after the surgery the patient developed swelling and redness at one of the port sites. The patient sought treatment from the surgeon who had operated upon him. The surgeon introduced a negative suction drain and was then periodically irrigating the operative site with an antibiotic solution. However there was no response to treatment. The negative suction tube was discharging frank pus. The daily output was approximately 15 to 20 cc per day. The patient then was refereed to me. On physical examination there was a firm indurated mass measuring approximately 13 cms in diameter with the tube drain exiting laterally from the mass (Figure 1). Figure 1: Swollen and reddened area with a sinus opening along with the drainage tube exiting from the lateral aspect. ABSTRACT Mesh infection is one of most disastrous complication following hernia surgery. The consequences are more complex especially following a laparoscopic hernia repair operation. Understanding the pathophysiology of mesh infections is pivotal in adopting preventive strategies. Once infected, exact determination of the extent of the septic complication by CECT is essential. A two staged surgical intervention yields excellent results. A case of infected laparoscopic mesh repair treated by a two staged operation is presented along with a brief review of literature to highlight the safety and efficacy of this approach. Keywords: Mesh infections, Hernia repair treatment Department of Surgery, D.Y. Patil University School of Medicine, Navi Mumbai-400706, Maharashtra, India Received: 05 March 2016 Revised: 09 March 2016 Accepted: 10 March 2016 *Correspondence: Dr. Ketan Vagholkar, E-mail: kvagholkar@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20160701