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General Surgery/hernia w/ mesh, infection

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Question
I had a rt inguinal hernia repair in '85, w/o mesh and all was fine. It recurred December 2011 and was incarcerated. I had open repair w/ mesh. I had pain going down right leg, numbness in rt groin, pain in groin that never let up. In Oct '13 I saw another surgeon as now there was a lump there. He thought it was another hernia and had another open surgery. It was not a hernia, but a mass of necrotic adipose tissue, a suture and a node. He opened the node and a liquefied purulent material came out, which was cultured and was a "friendly" staph, gram + cocci was found. I was on IV antibiotics for 2-3 days in hosp and sent home on Bactrim. This has not improved. I now have horrendous night sweats, extreme fatigue, cannot stay awake, intermittent fevers, joint pain, swelling in hands, nausea, profuse sweating, pain in right groin, burning in groin after sitting. I went back to surgeon, and he did U/S and CBC. Norm WBC's, U/S showed "scar tissue". After the 1st surgery, my WBC's were also norm and the U/S showed fluid that was "normal following surgery", however that was the infection! So, I waited 2 more months and saw him again a week ago. He said he doesn't feel an abscess so he doesn't want to touch it. I'm sure he doesn't want to see what's inside! So I made an app't to see original surgeon in 2 weeks. I know I am sick from this, and I know it's an infection or mesh problem. where do I go from here?

Answer
Dear Diane,

The reason the surgeon does not want to re-open you is because each time the abdomen is surgically explored, scar tissue develops. This leads to a host of complications, most notably small bowel obstructions. However, with your past history of an abscess, your symptoms described in you message, and the pain you are experiencing, I do think you may need an exploration to visualize the internal organs. I also recommend that you go to a primary care provider and get a thorough physical including bloodwork. This may be something unrelated to the mesh.  

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Dr. Pamela M. Cipriano, DNP, ACNP-BC

Expertise

GENERAL SURGERY Intestinal obstructions; Perforations; Ostomy; End ileostomy; Hemicolectomy; Take down ileostomy; Ostomy reversals; Diverticulitis; Chrohns Disease; Appendectomy; Cholecystectomy (gallbladder); Ventral hernia repair; Inguinal hernia repair; Umbilical hernia repair; Chest tubes; Pleurex catheters; Lobe-ectomy; Pneumonectomy; Thoracotomy; Pleuradesis; Thyroid surgery; Mastectomy; Lumpectomy LAPAROSCOPIC - LAPAROTOMY - LAPAROSCOPIC ASSISTED

Experience

My name is Dr. Cipriano. I am a Hospitalist on the Medical Staff. I round, admit, discharge, consult and assist with surgeries in the OR. I manage patients in the ICU and Med/Surg floors. I also work in the emergency department. I am certified critical care nurse (CCRN). And ACLS certified. I

Organizations
Society of Hospital Medicine American College of Nurse Practitioners Connecticut Advance Practice Registered Nurse Society

Education/Credentials
Maryville University 2014-2016 Doctor of Nursing Practice University of Connecticut 2007-2011 MSN, Acute Care Track Nurse Practitioner. Board Certified September 2011 Central Connecticut State University 2002-2006 BA Psychology St. Mary's Hospital School of Nursing 1991-1993 Diploma Nursing Registered Nurse

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