Use of the Mobile Post-Operative Wound Evaluator in the Management of Deep Surgical Site Infection after Abdominal Wall Reconstruction

Abstract

Background: Surgical site infections (SSIs) after ventral hernia repair typically occur after discharge from the hospital, making timely diagnosis difficult. Successful treatment of SSIs may require re-admission and weeks to months of care and follow-up visits, which is potentially costly and burdensome to patients. To address these challenges, we have developed the Mobile Post-Operative Wound Evaluator (mPOWEr), a mobile health application that allows patients to record and transmit SSI symptom data and photographs to clinicians. Case Presentation: A 45-year-old female underwent open repair of a large recurrent ventral hernia with component separation and synthetic mesh sub-lay. After noting a change in the character of her drain output and transmitting the information via mPOWEr, she was diagnosed with a deep SSI requiring re-admission, operative washout, and negative pressure therapy. This management resulted in mesh salvage and healing without hernia recurrence, documented serially using mPOWEr. Conclusions: Diagnosis and treatment of SSIs after ventral hernia repair is challenging for physicians and patients alike. Mesh salvage is feasible in deep SSIs involving lightweight macroporous polypropylene mesh, but may require protracted care. Mobile health solutions that allow transmission of patient-generated health data can facilitate early diagnosis of SSI and long-term monitoring of outpatient treatment.