Prevention of surgical site infection after gernioplasty: experimental and clinical study
Abstract
The most common problem in current hernia surgery is high risk of surgical site infection (SSI). Despite the advantages of mesh implants, their application in hernia surgery has its disadvantages, SSI risk increases.
The aim of the study was to evaluate bacterial adhesion on the polyester and polypropylene hernia implants in combination with biocides solution in experiment and clinical practice.
Material and methods. The adhesion of Staphylococcus aureus ATCC® 25923 and the clinical strains of S. aureus, S. epidermidis on monofilament surgical mesh implants – macroporous polyester and microporous polypropylene in combination with biocides was assessed in vitro during the experiment and clinical practice.
Results. Staphylococcus cells adhered to the surface of implant fragments without treatment with biocides within a few hours, and there was no significant effect on the adhesion of the structure or chemical composition of the fiber. Short-term exposure of implants to the solutions of amoxiclav (100 μg/ml) and chlorhexidine (0.05%) led to inhibition of bacterial growth and contamination of the surface for at least two days. In the experiment with vancomycin (100 μg/ml), bacterial cells adhered on the surface of the mesh fragments after 24 h, but their amount was significantly lower than in the control group. It was noted that both implants in combination with chlorhexidine were not contaminated with S. aureus for 2 days under conditions of a high concentration of cells in the suspension. The results of an experimental study were applied in hernioplasty in 77 patients with ventral and incisional hernias.
Conclusion. The use of biocide solutions for perioperative prevention of surgical site infection in experimental study and hernia surgery has reduced bacterial contamination of mesh implants.
Keywords:ventral hernia, incisional hernia, surgical site infection, biofilms, mesh implant, biocides
Conflict of interests. The authors declare no conflict of interests.
For citation: Samartsev V.A., Gavrilov V.A., Parshakov A.A., Kuznetsova M.V. Prevention of surgical site infection after gernioplasty: experimental and clinical study. Clin Experiment Surg. Petrovsky J. 2020; 8 (1): 12–21. doi: 10.33029/2308-1198- 2020-8-1-12-21 (in Russian)
Received 08.02.2019. Accepted 05.02.2020.
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