PMC9904804_01
Abdominal computed tomography scan obtained 1 month before prosthetic mesh explantation showing an intra-abdominal abscess measuring 9.5 cm x 2.3 cm deep within the abdominal wall and containing a few bubbles of gas. Percutaneous drains are seemingly well positioned.
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Drains were placed and fluid cultures were positive for methicillin-resistant Staphylococcusaureus (MRSA) and scant Peptoniphilus (Gram-positive anaerobic cocci) (Figure 1).
Abdominal comuted tomography scan obtained immediately before prosthetic mesh explantation revealing improved but residual intra-abdominal abscess under the abdominal wall with percutaneous drains seemingly well positioned.
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Despite drainage and antibiotic therapy with vancomycin, flagyl and levofloxacin as recommended by infectious disease consultants, purulent drainage continued and the patient remained clinically unwell (Figure 2).
Intraoperative photograph depicting the percutaneous drain after explantation of the overlying prosthetic mesh with salvage of the underlying bioprosthetic mesh.
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However, at elective laparotomy there was an abscess cavity overlying the synthetic mesh, and the synthetic mesh was explanted; the biologic mesh was intact and left in place (Figure 3).