Wound infection following repair of abdominal wall hernia
- Anne T Mancino, MD
Anne T Mancino, MD
- Associate Professor of Surgery
- University of Arkansas of Medical Sciences
- Tahaniyat Lalani, MBBS, MHS
Tahaniyat Lalani, MBBS, MHS
- Assistant Professor
- Uniformed Services University of the Health Sciences
- Section Editors
- Michael Rosen, MD
Michael Rosen, MD
- Section Editor — Hernia Surgery
- Professor of Surgery
- Cleveland Clinic Foundation
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
The repair of an abdominal wall hernia is a generally clean procedure with a low risk of infectious complications. However, when wound infections do occur following a hernia repair, they can be associated with hernia recurrence, mesh infections, and systemic complications [1,2].
Abdominal wall hernia repairs can be divided into two broad categories:
●Ventral hernia repair – includes incisional, ventral, epigastric, spigelian, peristomal, and umbilical hernias. (See "Overview of abdominal wall hernias in adults".)
●Groin hernia repairs – includes inguinal and femoral hernias. (See "Classification, clinical features and diagnosis of inguinal and femoral hernias in adults".)
Risk factors for and strategies to reduce the risk of infection after abdominal wall hernia repair are reviewed here. An overview of antibiotic prophylaxis and other control measures to prevent surgical site infection are discussed elsewhere. (See "Antimicrobial prophylaxis for prevention of surgical site infection in adults" and "Adjunctive measures for prevention of surgical site infection in adults".)
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- EPIDEMIOLOGY AND RISK FACTORS
- Hernia location
- Clinical and intraoperative factors
- Open versus laparoscopic hernia repair
- Mesh-related factors
- - Non-mesh versus mesh repairs
- - Nonabsorbable versus absorbable mesh
- - Location of mesh placement
- - Complicated hernia repair
- Placement of drains
- CLINICAL FEATURES AND DIAGNOSIS
- Diagnosis of postoperative wound infection
- Wound/fluid cultures
- - Microbiology
- DIFFERENTIAL DIAGNOSIS
- Superficial wound infection
- Deep wound/mesh infection
- MEASURES TO PREVENT RECURRENT INFECTION
- SUMMARY AND RECOMMENDATIONS