分析无张力疝修补术后补片感染再手术的临床疗效。

回顾性分析2019年10月至2023年8月安徽医科大学第一附属医院收治的32例无张力疝修补术后补片感染患者的临床资料，32例患者均在全身麻醉下行清创术，即亚甲蓝辅助染色、取出补片、冲洗伤口和负压封闭引流。分析术中情况、术后细菌培养和药敏及最终疗效。

32例患者均成功经手术完全取出感染补片，其中单纯补片取出10例（31.3%），取出感染补片并术中重新置入补片1例，补片取出联合窦道切除或肠管部分切除21例（65.6%），包含3例同时行肠管部分切除术。感染部位细菌药敏提示：多数为以金黄色葡萄球菌为主的单一感染，对喹诺酮类及β内酰胺类抗生素较敏感。术后患者均顺利出院，随访感染复发5例，疝单纯复发2例。

无张力疝修补术后补片感染一经发现，应早期治疗，手术治疗过程中，合理使用亚甲蓝辅助清创、完整取出补片、严格冲洗伤口、负压封闭引流和术后个体化抗生素应用是安全可靠的治疗方式。

To analyze the clinical reoperation efficacy of postoperative mesh infection with tension-free hernia repair surgery.

A retrospective analysis was conducted on the clinical data of 32 patients with postoperative mesh infection after tension-free hernia repair at the First Affiliated Hospital of Anhui Medical University from October 2019 to August 2023. All 32 patients underwent debridement under general anesthesia, including methylene blue assisted staining, mesh removal, wound flushing, and negative pressure closure drainage. Intraoperative situation, postoperative bacterial culture and drug sensitivity, and final therapeutic effect were analyzed.

One case underwent intraoperative replacement of a mesh, while three cases underwent partial intestinal resection simultaneously. Bacterial susceptibility from infection site indicates that most cases are single infections mainly caused by Staphylococcus aureus, which are sensitive by Quinolone drugs and β-Lactamide antibiotics. All patients were discharged from the hospital successfully. Postoperative follow-up showed 5 cases of infection recurrence and 2 cases of simple hernia recurrence.

Mesh infection after tension-free hernia repair should be treated early. During the surgical treatment, the rational use of methylene assisted debridement, complete removal of the mesh, strict flushing of the wound, negative pressure sealing drainage, and postoperative individualized antibiotic application are safe and reliable treatment methods.