PMC6260369_01
Physical examination: The umbilicus (arrowhead) was positioned toward the right side because of a mass. A reducible mass (arrow) at the left upper quadrant corresponding to about 30 cm.
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On physical examination (Fig. 1), the patient weighed 57.9 kg, has a height of 165 cm, and a body mass index of 21.3.
Computed tomography (CT) findings. CT revealed a 17 x 13 cm incisional hernia from the ninth rib to the left flank.
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The hernia contained the small intestines (Fig. 2).
Postoperative day 26 wound findings: 3 x 7 cm mesh exposure due to wound dehiscence without infection.
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On postoperative day 26, we detected that a 3 x 7 cm mesh was exposed due to wound dehiscence (Fig. 3).
Re-operation procedure. (A) Put a crystal violet on the exposed mesh. (B) Local removal of the exposed mesh. Adhesion and abscess were not detected. (C) Overlapping the remaining mesh by 5 mm with 1-0 nonabsorbable suture and retention sutures in the skin. (D) Nodules concealed between meshes to prevent skin damage at the nodules.
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Although the general condition was improving, the wound dehiscence extended; hence, we performed mesh trimming and suture reconstruction (Fig. 4).
Final wound appearance. The wound is clear without infection and dehiscence at discharge.
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The postoperative course was uneventful (Fig. 5).