Abstract

Postoperative incisional hernias are common complications following abdominal surgeries, necessitating timely repair to mitigate the risk of incarceration. Mesh repair has become standard practice, yet surgical site infections (SSIs) and subsequent mesh infections remain significant challenges. Negative Pressure Wound Therapy (NPWT) has emerged as a promising adjunctive treatment for enhancing wound healing and reducing infection rates. This Case Series Analysis compared the efficacy of Negative Pressure Wound Therapy and conventional treatment in managing surgical site and mesh infections in patients after incisional hernia repair. A total of 413 patients between October 2018 and October 2022 were included, with 37 developing surgical site infections. Seventeen patients received Negative Pressure Wound Therapy (Group 1), while twenty patients received conventional dressing and systemic antibiotics (Group 2). Patient demographics, comorbidities, treatment duration, and post-treatment outcomes were analyzed. Group 1 demonstrated a significantly higher healing rate (88.2%) compared to Group 2 (55%). Negative Pressure Wound Therapy was associated with a lower rate of mesh removal and secondary surgeries. However, treatment duration was longer in the Negative Pressure Wound Therapy group. Larger mesh areas were correlated with treatment failure. Negative Pressure Wound Therapy offers superior outcomes in managing surgical site infections and mesh infections following incisional hernia repair compared to conventional dressing. Despite longer treatment durations, Negative Pressure Wound Therapy reduces the need for mesh removal and mitigates complications associated with secondary surgeries. Prospective randomized clinical trials are warranted to validate these findings and assess long-term outcomes and cost-effectiveness.

Key words: Incisional hernia, Mesh infections, Negative Pressure Wound Therapy, Mesh repair