探讨腹股沟疝无张力修补术后补片相关性切口感染的处理策略。

回顾性分析2003年1月至2016年12月中山大学附属第五医院收治的22例腹股沟疝无张力修补术后切口感染病例的临床表现、细菌培养、处理及预后情况，探讨其处理策略。

细菌培养情况：22例患者中17例（77.3%）细菌培养阳性，其中8例（47.1%）金黄色葡萄球菌，5例（29.4%）表皮葡萄球菌，4例（23.5%）大肠埃希菌。22例患者经过抗感染治疗和局部引流换药处理，13例痊愈，痊愈后1年内未复发；9例术后感染病程超过6个月，12个月后均采取手术完全去除补片，其中5例一期缝合，局部放置胶管引流患者，切口痊愈平均时间（21.5±4.5）d，1例（20.0%）复发；4例清创术后切口敞开引流，伤口痊愈平均时间（23.3±5.0）d，无复发病例。

腹股沟疝无张力修补术切口浅层感染多数经保守治疗可以痊愈，但是对于反复发作、超过6个月未痊愈的深层感染，应手术完全去除补片，彻底清创，敞开引流可以获得痊愈的同时避免复发。

To investigate the treatment strategy of incisional infection associated with mesh repair after tension-free repair of inguinal hernia.

A retrospective analysis was carried out of twenty-two incisional infection cases in the Fifth Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2016 of the clinical manifestations, bacterial culture, treatment and prognosis, and to explore its treatment strategy.

Among the 22 cases of post-operative infection, 17 cases (77.3%) were positive for bacterial culture, including 8 cases (47.1%) of Staphylococcus aureus, 5 cases (29.4%) of surface Staphylococcus and 4 cases (23.5%) of Escherichia coli. The infected patients were treated with anti-infection therapy, local drainage and dressing change. Thirteen patients were cured, and no recurrence occurred 1 year after recovery. The infection course was more than 6 months in 9 cases. After 12 months, all the patches were removed completely. Among them, 5 cases underwent primary suture and local hose drainage. The average healing time of incision was (21.5±4.5) days, and 1 case recurred. The recurrence rate was 20.0%. The average time of wound healing was (23.3±5.0) days in 4 patients with open wound drainage after debridement, and no recurrence occurred.

Most of the superficial incisional infection after tension-free repair can be cured by conservative treatment. However, for deep infections that have not been cured for more than 6 months, the patch should be completely removed and thoroughly debrided. Open drainage can be cured and avoid recurrence.