Objective To evaluate the prevention and treatment of prosthetic infections after tension free hernioplasty. Methods The clinical date of 12 prosthetic infections admitted from May 2005 to May 2008 were analyzed retrospectively. Patch was inserted under prefascial retromuscular site in 8 cases, between fascial edges in 2, Mesh plug and patch Lichentstein in one each. As for the material used there were flat knitted polypropylene in 7 cases, polytef in 1 case and composite prosthesis in 4 cases. Treatments were based on prothetic materials and levels infected. Infectious patchs were removed completely in 8 cases and partially removed in 2 cases, Open dress change with patchs left in situ in 2 cases. 3 cases in 10 cases of removed patchs were given immediate suturation with closed drainage. Results Infection was cured in all cases without mortality. There was no hemorrhage and injury of bladder during the procedures. No retention of urine, pain and other complications during postoperation. Change of dressing was made from 7 days to 6 months( median 2 weeks). Selected antibiotic was used from 3 to 7 days (average 4.5 days). All patients were followed up from 18 to 78 months (average 38.5 months) without hernia recurrence and infection. Conclusion It was most important to prevent infections after tension-free hernioplasty. Management should be individualized according to different type of patch used and the surgical procedure in hernia repair.%目的 探讨疝补片感染的发病原因、预防和治疗.方法 回顾性总结分析2000年5月至2008年5月陕西省人民医院收治的12例使用无张力疝修补手术后发生补片感染病例的临床资料.其中筋膜前(或腹膜前)肌下置入补片8例,补片置入在筋膜缺损缘间2例.疝环填充式无张力疝修补术1例,平片修补术1例.单纯聚丙稀补片7例;聚丙稀与聚四氟乙烯双面复合材料4例;聚四氟乙烯材料1例.根据感染的程度、材料不同采用相应的治疗方法.8例全部去除补片;2例部分去除补片;2例仅开放换药.去除补片后3例给予一期缝合,封闭式引流.结果 全组患者均治愈出院,无围手术期死亡,手术过程中无大出血和膀胱损伤.手术后无疼痛和尿潴留及其他并发症.换药时间7 d至6个月,中位时间2周,选择性使用抗生素3～7 d,平均4.5 d,随访时间18～78个月,平均38.5个月,未见感染,部分或完全取出补片的患者未见疝复发.结论 预防感染的发生最为重要,治疗方法应个体化,根据不同的手术类型和材料选择不同的治疗措施.
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