Diagnosis and treatment strategies for patch infection after inguinal hernia surgery

doi:10.3877/cma.j.issn.1674-392X.2025.03.016

Abstract

Abstract:

Inguinal hernia is a common surgical disease. Tension-free hernia repair has been proven to be the most effective method for treating this disease， significantly reducing the recurrence rate of hernia. Meanwhile， postoperative patch infection， as one of the serious complications of tension-free repair， brings great psychological and physiological pain and economic burden to patients， and has become the focus of everyone's attention. At present， there is no consensus on the diagnosis and treatment of mesh infection after inguinal hernia surgery. Therefore， this article reviews the progress in the diagnosis and treatment of postoperative mesh infection in inguinal hernia， in order to provide reference for formulating reasonable treatment plans and improving treatment effectiveness.

Key words: Hernia, inguinal, Mesh infection, Diagnosis, Treatment

Keyi Wang, Chong Wu, Hansong Liu, Lei Gao. Diagnosis and treatment strategies for patch infection after inguinal hernia surgery[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(03): 331-334.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2025.03.016

https://zhshfbwkzz.cma-cmc.com.cn/EN/Y2025/V19/I03/331

Figures/Tables 1

References 25

［1］	中华医学会外科学分会疝与腹壁外科学组，中国医师协会外科医师分会疝和腹壁外科专家工作组，唐健雄，等. 腹股沟疝诊疗指南（2024版）［J］. 中国实用外科杂志， 2025， 45（2）：121-127.
［2］	Chen T， Zhang YH， Wang HL， et al. Late-onset Deep Mesh Infection：A Study of Eight Cases Detected from 2666 Consecutive Patients with Abdominal Wall Hernia Repairs［J］. Chin Med J（Engl）， 2016，129（15）：1870-1872.
［3］	Racareanu M， Preda S， Patrascu Ș， et al. Impact Of Comorbidities On Outcomes And Healthcare Costs Of Open Inguinal Hernia Repair In Patients With Diabetes Mellitus［J］. Chirurgia（Bucur）， 2024， 119（2）：227-234.
［4］	杨良根，朱俊强，胡星辰. 腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝［J］. 外科理论与实践， 2022， 27（6）：551-554.
［5］	邹振玉，曹金鑫，朱熠林，等. 腹腔镜腹股沟疝修补术后补片感染的外科治疗［J］. 中华消化外科杂志， 2023， 22（9）：1080-1085.
［6］	张继盛，李冰震，马柏强. 腹股沟疝术后发生感染的病菌分布及因素分析［J］. 浙江创伤外科， 2023， 28（9）：1725-1728.
［7］	何万鹏，彭超. 腹腔镜下经腹腔腹股沟疝补片修补术治疗隐匿性腹股沟疝的临床效果观察［J］. 实用医院临床杂志， 2023， 20（1）：150-152.
［8］	He L， Wang X， Fan G， et al. Hernia mesh infection treatment following the repair of abdominal wall hernias：A single-center experience［J］. Front Surg， 2022， 9：993855.
［9］	Zeb MH， Pandian TK， El Khatib MM， et al. Risk factors for postoperative hematoma after inguinal hernia repair：an update［J］. J Surg Res， 2016， 205（1）：33-37.
［10］	杨建军，李绍春，李绍杰，等. 生物材料补片和合成材料补片对老年腹股沟疝修补术后患者血清肿发生率的影响比较［J］. 老年医学与保健， 2022， 28（4）：887-891.
［11］	王江，阎大益，彭微，等. 腹股沟疝患儿腹腔镜经皮腹膜外闭合术后疝复发及对侧腹股沟疝发生的危险因素分析［J］. 中国现代医学杂志， 2021， 31（11）：75-80.
［12］	聂玉胜，熊尧，杨慧琪，等. 不同类型补片在食管裂孔疝修补术中应用的研究［J］. 中华普通外科杂志， 2022， 37（2）：104-107.
［13］	管延旭，王伟. TGF-β1、TIMP-2、CGRP在腹股沟疝术后感染患者中的表达及意义［J］. 中国实验诊断学， 2024， 28（1）：51-53.
［14］	刘鹭，穆磊，周毅. 腹股沟疝无张力修补术后补片感染的诊疗分析［J］. 临床外科杂志， 2019， 27（9）：751-753.
［15］	邹劲林，莫湘琼，牛斌，等. 腹股沟疝无张力修补术后切口感染的处理［J/OL］. 中华普通外科学文献（电子版）， 2019， 13（4）：308-311.
［16］	Gossetti F， D'Amore L， Annesi E， et al. Mesh-related visceral complications following inguinal hernia repair：an emerging topic［J］.Hernia， 2019， 23（4）：699-708.
［17］	Ito H， Matsumoto K， Terauchi T， et al. Delayed mesh infection after inguinal hernia repair：a case report［J］. J Surg Case Rep， 2021，2021（9）：rjab399.
［18］	刘力嘉，李原，陈思梦. CT扫描在腹壁修补术后补片感染中的诊断应用［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2021， 15（5）：459-465.
［19］	Zou Z， Cao J， Zhu Y， et al. Treatment of mesh infection after inguinal hernia repair：3-year experience with 120 patients［J］. Hernia， 2022，27（4）：927-933.
［20］	杨瑞洲，李国栋，吴向阳. 腹股沟疝术后感染的治疗方法探讨［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2023， 17（6）：715-719.
［21］	杨慧琪，刘亦婷，陈杰，等. 腹股沟疝修补术后补片感染的个体化手术治疗［J］. 中华普通外科杂志， 2019， 34（9）：795-797.
［22］	田利飞，仝聪，阎立昆，等. 三人四孔法在腹腔镜腹股沟疝感染补片取出术中的应用观察［J］. 山东医药， 2022， 62（33）：23-26.
［23］	Quiroga-Centeno AC， Quiroga-Centeno CA， Guerrero-Macías S， et al. Systematic review and meta-analysis of risk factors for Mesh infection following Abdominal Wall Hernia Repair Surgery［J］. Am J Surg， 2022， 224（1 Pt A）：239-246.
［24］	Marcolin P， Mazzola Poli de Figueiredo S， Walmir de Araújo S， et al.Preoperative Optimization Before Ventral Hernia Repair：A Systematic Review and Meta-analysis［J］. Surg Laparosc Endosc Percutan Tech， 2023， 33（2）：211-218.
［25］	Labay C， Canal JM， Modic M， et al. Antibiotic-loaded polypropylene surgical meshes with suitable biological behaviour by plasma functionalization and polymerization［J］. Biomaterials， 2015， 71：132-144.

术式	创伤程度	视野与操作	术后疼痛	切口愈合风险	技术依赖性
开放	切口较大，需切开多层组织，损伤范围广	肉眼直接观察补片及周围组织；清创、移除补片操作直观，能彻底清除感染组织	明显，活动时加剧	感染严重时切口愈合受影响；瘢痕明显，影响美观	无需特殊设备
腹腔镜	切口小，对组织损伤小，出血少	借助腹腔镜高清镜头，视野清晰，对补片周围感染范围、脓肿及粘连情况观察较清晰；清创和移除补片时操作精确，可减少正常组织损伤；可以同时观察腹腔内其他部位的情况排除潜在的感染源；在感染严重、脓肿范围较大时，操作难度会相应增加	轻微，对日常活动影响小	切口感染率低，愈合快；瘢痕小且隐蔽，美观性好	依赖腹腔镜设备，需术者具备熟练的腔镜技术

术式	创伤程度	视野与操作	术后疼痛	切口愈合风险	技术依赖性
开放	切口较大，需切开多层组织，损伤范围广	肉眼直接观察补片及周围组织；清创、移除补片操作直观，能彻底清除感染组织	明显，活动时加剧	感染严重时切口愈合受影响；瘢痕明显，影响美观	无需特殊设备
腹腔镜	切口小，对组织损伤小，出血少	借助腹腔镜高清镜头，视野清晰，对补片周围感染范围、脓肿及粘连情况观察较清晰；清创和移除补片时操作精确，可减少正常组织损伤；可以同时观察腹腔内其他部位的情况排除潜在的感染源；在感染严重、脓肿范围较大时，操作难度会相应增加	轻微，对日常活动影响小	切口感染率低，愈合快；瘢痕小且隐蔽，美观性好	依赖腹腔镜设备，需术者具备熟练的腔镜技术

[1]	Yan Wang, Xiaohang Zhang, Suzhen Ran, Chunyan Zhong, Jinwei Zhang, Xi Wang. Prenatal ultrasonographic features of twin anemia-polycythemia sequence: analysis of 26 cases [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(05): 462-469.
[2]	Yin Chen, Ying Tan, Bohan Tan, Guannan He, Lei Wang, Xin Wen, Qiaozhen Zhu, Bocheng Liang, Shengli1 Li. Intelligent quality assessment and diagnosis of fetal omphalocele using YOLO V8 in ultrasound imaging [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(04): 305-310.
[3]	& Endoscopic Surgery Group, Branch of Surgery, Chinese Medical Association Laparoscopic, Cancer Professional Committee, China Anti-Cancer Association Gastric, and Robotic Surgical Society, China Anti-Cancer Association Endoscopic, Board of the Chinese Journal of Digestive Surgery Editorial. Expert consensus on precision surgery for gastric cancer conversion therapy （2025 edition） [J]. Chinese Archives of General Surgery(Electronic Edition), 2025, 19(03): 145-156.
[4]	Min Yang, Jiangxiu Liao, Guozhi Zhang, Ye Zhang, Linjun Fan. The preoperative diagnostic value of conventional ultrasound combined with clinical features for central lymph node metastasis in papillary thyroid microcarcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 396-400.
[5]	Shiwang Huang, Yunkai Qie, Hailong Hu. Application of artificial intelligence in non-invasive urine-based diagnostic methods for bladder cancer [J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(03): 283-287.
[6]	Hong Zeng. Interpretation of commonly used immunohistochemical markers in pathological reports of bladder cancer [J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(03): 296-302.
[7]	Qiang Ding, Xiang Dong, Weidong Gan. Differential diagnosis of TFE3-rearranged renal cell carcinoma and clear cell renal cell carcinoma based on dynamic-enhanced CT and clinical features [J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(03): 329-334.
[8]	Xiaodong Tan, Qiang Dai, Jin Zhang, Peng Huang, Xin Zhang, Shanshan Chen, Hongxue Zhu, Zili Wang. Analysis of factors influencing the clinical efficacy of emergency extracorporeal shock wave lithotripsy in the treatment of ureteral calculi [J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(03): 359-364.
[9]	Guorong Yang, Chenxi Ye, Heng'en Wang, Jie Wang, Qiang Hu, Qing Yuan, Tao Song. Application of prostate three-dimensional reconstruction imaging in preoperative patient education for benign prostatic hyperplasia [J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(03): 365-371.
[10]	Zhenling Ji, Zonghang Liu. How to repair the esophageal hiatus defect during hiatal hernia repair [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(03): 245-252.
[11]	. Recent advances in surgical strategies for hepatic alveolar echinococcosis [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 475-480.
[12]	Society for Hepato-pancreato-biliary Surgery of Chinese Research Hospital Association, Editorial Board of Chinese Journal of Digestive Surgery. Guideline for diagnosis and treatment of perihilar cholangiocarcinoma （2025 edition） [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 317-337.
[13]	Limin Liu, Zongming Zhang, Yue Zhao, Chong Zhang, Zhuo Liu, Hui Qi. Progress and current status of prevention and treatment of iatrogenic bile duct injury [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 346-353.
[14]	Minjie Lin, Chennan Xu, Zhiming Wu. Prevention and treatment of bleeding during laparoscopic hepatectomy [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 360-365.
[15]	Weimin Mao, Zhujing Lan, Banghao1 Xu, Hai Zhu, Jilong Wang, Zongrui Jin, Bingcheng Meng, Tingting Lu, Jingjing Zeng, Zili Lyu, Rui Song, Zhang Wen. Clinical diagnosis and treatment of 14 cases of hepatic sarcomatoid carcinoma [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 435-441.

Please choose a citation manager

Content to export