A comparative study of type of infective organisms and their antimicrobial sensitivity in Mesh infection in ventral hernia repair between diabetic and non diabetic patients

Viswakumar, P (2014) A comparative study of type of infective organisms and their antimicrobial sensitivity in Mesh infection in ventral hernia repair between diabetic and non diabetic patients. Masters thesis, Stanley Medical College, Chennai.

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Abstract

BACKGROUND: Ventral hernia are the most frequently encountered hernia in a surgeons day today practice. Most common among them was incisional hernia which contributes about 15 to 20%.Most of the repairs now a days done using prosthetic mesh and hence its complication rate also increases. Prosthetic mesh infection is a catastrophic complication of ventral hernia repair. AIMS & OBJECTIVES: 1) To find out the type of infective organisms causing mesh infection between diabetic and non diabetic patients. 2) To know the antibiotic sensitivity of those organisms. 3) To choose appropriate antibiotic prophylaxis and treatment. 4) To compare the commonest organism prevalent between diabetic and non diabetic patients. 5) To find out effect of other comorbid conditions associated with mesh infection. METHODS: About 53 patients with mesh infection was included in study. The risk factors such as diabetes, obesity, COPD, smoking history were studied. To determine the microbial organisms between diabetic and non diabetic patients with mesh infection, culture were taken from DT fluid, exudate directly over the mesh incase exposed mesh and their antibiotic sensitivity was studied. The results were tabulated and compared with both the group of patients. RESULTS: From our study group we found among the risk factors diabetic was most important risk factor contributing about 57%.Most of this group of patients developed wound infection which in turn leads to development of mesh infection. Among diabetic patient Klebseilla pneumonia (51%) was most common organism followed by pseudomonas aeruginosa and both are sensitive to Amikacin (73%) followed by ciprofloxacin. In non diabetic group stap.aureus was commonest organism (43%) followed by Stap.epidermidis and Stap.aureus sensitive to Ampicillin and cefotaxime while Stap.epidermidis to Linzolid and Vancomycin in our institution. CONCLUSION: Mesh infection is a catastrophic complication of ventral hernia mesh repair causing considerable morbidity to patient and increase in health care cost for hospital too. So Higher-quality reporting on mesh infection in VIH repair must be achieved through better classification and quantification of these infections. Tactics to avoid mesh infection should be based on best evidence from prospective studies of each institution and following appropriate antibiotic prophylaxis based on their results as in our institution.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Ventral hernia ; Mesh infection ; Diabetic ; Prosthetic mesh ; Klebsiella ; Stapylococcus aureus.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jul 2018 03:44
Last Modified: 05 Jul 2018 17:56
URI: http://repository-tnmgrmu.ac.in/id/eprint/8646

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