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Suggest Treatment For Mesh-serous Collection After Umbilical Hernia Repair

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Posted on Wed, 27 Apr 2016
Question: my mother is 46 years old and on 23rd december she underwent 2 operations namely uterus removal (ovaries preserved) and for umbilical hernia. The uterus operation has healed well. but the problem is with hernia, A mesh was places during hernia repair. She seemed to be healing until on 5th Feb onwards we noticed liquid coming out of her naval , where hernia was repaired. We had the liquid tested but it had no bacterial growth in culture reports etc. She has no pain, no swelling no redness in the area only the fluid keeps leaking. The ultrasonography report shows collection of fluid .In order to avoid infection she was given a week of antibiotic . The surgeon who operated her has said that it is perhaps the mesh which the body is not accepting and so if the fluid doesnt stop itslef in maximum 2 months they will reoperate and change the mesh. Another physician told us that this is very common in any surgery and all that needs to be done is a minor wound is to be created in the area where the liquid is forming and then it will heal itself and it has got nothing to do with the mesh. Also my mother is in the prediabetic stage. Please help us with our situation.
doctor
Answered by Dr. Mukund Savaskar (1 hour later)
Brief Answer:
Post Mesh-Serous Collection after Umbilical Hernia Repair/Evaluation

Detailed Answer:
Brief Ans-Post Mesh-Serous Collection after Umbilical Hernia Repair/Evaluation

Hi Dear!! Thanks for your query to HCM.
Read and reviewed your query in context to your health issues for treatment of serous discharge, while you are in 6 th week post-umbilical hernia repaired by Mesh.

My Perception of Your Problem-
Before considering Reaction to Mesh,as its rare, I would suggest you to be rule out following risk factors- currently present in this case-
-Its only 6th week post surgery , where the USG confirmed fluid Collection.
And being Pre-diabetic- she is more prone to sub-clinical / or antibiotic masked infection.
- and Hence with proper wound care, the mesh- wound needs to be given chance to heal and No Removal at this stage of wound healing , with close watch on progress-under cover from attending Surgeon.

Remedy for treating Serous Discharge
Hence the best possible Way out in your case would be as follows-
-In the given Circumstances as noticed above, I would suggest to -have proper drainage of the serous collection by making wide opening for the drainage of the collected fluid / this with pressure dressings x 2 weeks, would give you relief from serous discharge
-Before planning this, I would suggest you to send the serous discharge for -Culture study to fix the exact antibiotic cover for your case.
-Besides this -check for your BSL-F/ PP for any rise.
-With all this precautions-and if needed with insulin cover, if need be,
- antibiotic cover with Metronidazole and Ofloxacin- combination-for 10 days, would give better relief,as the wound would heal in next 10-14 days time.
-Crux of the Management would be proper daily dressings/ with padded and Pressure dressings to control the fluid collection in space around the mesh.
-Supplementary aids with - Tab Zincovit /
Iron treatment for any accompanied anaemia /
High protein bland diet would help you for fast recovery.

My Opinion-Understanding the cause of this problem-
You never had general reaction complaints suggesting allergic reaction in last 5 weeks(possibility of material allergy is very remote).
Hence yours is just a case of post-operative wound haematoma, which is resolving but in given pre-diabetic state of your mother, is with Collected fluid, which needs to be drained by "Meticulous - wound care " by Surgeon Himself personally, without depending on his assistants for the dressings.
This is the key to- coming out of this complex and anxious situation in which your mother is in.

Please Keep Me updated after 10 days of post- operative care on the lines given and after USG study for the recovery of the fluid space.

I am sure to hear positive progress and resolution of your mothers post-operative wound healing.
To DO-list-for YOU-
Send the Serous wound fluid for CULTURE study to find out Antibiotic
Treat with medicines as suggested -which your doctor would help you.
Rest / good diet / Proper Dressing Care with proper drainage and with Pressure dressings , to let the wound heal on its ownx 10 days.
Check for any rise in blood sugar and take cover with insulin-if need be -with expert advise of Physician / Surgeon.
Re-Check USG- after 2 weeks- and Update with Your doctor and with Me, by private Direct Question with demand for My services specifically.

Hope this would help you to cool down and manage your case with the right doctor, as suggested from the above discussion.

I would not comment on opinion of your doctors, but by My opinion I have made it crystal clear as how to go ahead in your Mother's case.

Wishing you fast and good recovery !!
Welcome for any further query in this regard.

Good Day !!

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3606 Questions

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Suggest Treatment For Mesh-serous Collection After Umbilical Hernia Repair

Brief Answer: Post Mesh-Serous Collection after Umbilical Hernia Repair/Evaluation Detailed Answer: Brief Ans-Post Mesh-Serous Collection after Umbilical Hernia Repair/Evaluation Hi Dear!! Thanks for your query to HCM. Read and reviewed your query in context to your health issues for treatment of serous discharge, while you are in 6 th week post-umbilical hernia repaired by Mesh. My Perception of Your Problem- Before considering Reaction to Mesh,as its rare, I would suggest you to be rule out following risk factors- currently present in this case- -Its only 6th week post surgery , where the USG confirmed fluid Collection. And being Pre-diabetic- she is more prone to sub-clinical / or antibiotic masked infection. - and Hence with proper wound care, the mesh- wound needs to be given chance to heal and No Removal at this stage of wound healing , with close watch on progress-under cover from attending Surgeon. Remedy for treating Serous Discharge Hence the best possible Way out in your case would be as follows- -In the given Circumstances as noticed above, I would suggest to -have proper drainage of the serous collection by making wide opening for the drainage of the collected fluid / this with pressure dressings x 2 weeks, would give you relief from serous discharge -Before planning this, I would suggest you to send the serous discharge for -Culture study to fix the exact antibiotic cover for your case. -Besides this -check for your BSL-F/ PP for any rise. -With all this precautions-and if needed with insulin cover, if need be, - antibiotic cover with Metronidazole and Ofloxacin- combination-for 10 days, would give better relief,as the wound would heal in next 10-14 days time. -Crux of the Management would be proper daily dressings/ with padded and Pressure dressings to control the fluid collection in space around the mesh. -Supplementary aids with - Tab Zincovit / Iron treatment for any accompanied anaemia / High protein bland diet would help you for fast recovery. My Opinion-Understanding the cause of this problem- You never had general reaction complaints suggesting allergic reaction in last 5 weeks(possibility of material allergy is very remote). Hence yours is just a case of post-operative wound haematoma, which is resolving but in given pre-diabetic state of your mother, is with Collected fluid, which needs to be drained by "Meticulous - wound care " by Surgeon Himself personally, without depending on his assistants for the dressings. This is the key to- coming out of this complex and anxious situation in which your mother is in. Please Keep Me updated after 10 days of post- operative care on the lines given and after USG study for the recovery of the fluid space. I am sure to hear positive progress and resolution of your mothers post-operative wound healing. To DO-list-for YOU- Send the Serous wound fluid for CULTURE study to find out Antibiotic Treat with medicines as suggested -which your doctor would help you. Rest / good diet / Proper Dressing Care with proper drainage and with Pressure dressings , to let the wound heal on its ownx 10 days. Check for any rise in blood sugar and take cover with insulin-if need be -with expert advise of Physician / Surgeon. Re-Check USG- after 2 weeks- and Update with Your doctor and with Me, by private Direct Question with demand for My services specifically. Hope this would help you to cool down and manage your case with the right doctor, as suggested from the above discussion. I would not comment on opinion of your doctors, but by My opinion I have made it crystal clear as how to go ahead in your Mother's case. Wishing you fast and good recovery !! Welcome for any further query in this regard. Good Day !! Dr.Savaskar M.N. XXXXXXX Surgical Specialist