Mesh infection salvage with locally bee-honey application.

Esmer David, phd, Salas Monica, phd, Alvarez-tostado Fernando, phd, Muniz Alejandro, phd. Central Hospital.

Mesh infection is a catastrophic complication after hernia repair. Honey has bactericidal activity reported since 1892.
Present 4 cases of salvage of infected mesh after abdominal hernia repairs with bee-honey.

Presentation.
Case 1: 34 years old man with incisional ventral hernia repair, presented with infection and mesh exposure. Antibiotics and daily lavage for three weeks improved the wound environment and skin grafts were placed. However, the skin grafts were lost secondary to re infection and the mesh was exposed again. Topical honey application successfully controlled the infection and the patient was discharged. By the 4th week the wound healed completely.

Case 2: 56 years old female with ventral hernia with loss of domain repaired with mesh after pre-operative progressive pneumoperitoneum . Ten days after surgery presented with dehiscent wound and mesh infection. The wound was open and drained and bee-honey application was started. The patient was discharged at the third day and by the 5th week the wound was healed..

Case 3: 69 years old women presented with mesh infection one month after ventral hernia repair. high white blood cell count… Antibiotic therapy and wound irrigation plus application of bee-honey was started. Sepsis control was achieved by 72 hours and the patient discharged on the 5th day. By the end of the 6th wek the wound was completely healed.

Case 4:45 years old woman with colostomy for sigmoidectomy secondary to perforated diverticulum and abdominal sepsis 5 years before admission. Several attempts of unsuccessful intestinal reconnections had been performed previously. She presented with huge incisional hernia which was repaired with mesh using pre-operative progressive pneumoperitoneum. The mesh became infected and wound irrigation plus application of bee-honey was started. The wound was completely healed by the 6th week.

Discussion: It is estimated that the frequency of any type of mesh infection is 1.3%. Honey has direct and indirect actions in the control of local wound infection and healing. There are a variety of bee-honey but honeys of all geographic areas have effective antimicrobial activity.

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