11008 Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (List separately in addition to code for primary procedure)

Name of the Procedure:

Removal of Prosthetic Material or Mesh, Abdominal Wall for Infection
(Common names: Mesh Removal, Abdominal Wall Mesh Extraction)

Summary

This procedure involves surgically removing infected prosthetic material or mesh from the abdominal wall. It is typically required for patients suffering from chronic or recurrent infections related to previously inserted mesh or prosthetic materials.

Purpose

The primary goal of this procedure is to eliminate sources of infection caused by the prosthetic material or mesh. This helps to manage and resolve chronic or recurrent infections and promotes healing of the abdominal wall tissue.

Indications

• Chronic or recurrent mesh infection
• Necrotizing soft tissue infection
• Persistent pain or drainage at the site of the mesh
• Non-healing wounds related to the mesh
• Severe inflammation or abscess formation

Preparation

• Fasting for at least 6-8 hours prior to the procedure.
• Discontinuation or adjustment of certain medications, as advised by the healthcare provider.
• Preoperative blood tests and imaging studies (e.g., CT scan or ultrasound) to assess the extent of the infection.
• Possible administration of antibiotics before the procedure to manage infection.

Procedure Description

1. Anesthesia: General anesthesia is typically administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made near the site of the infected mesh.
3. Exposure: The abdominal wall and infected area are carefully exposed.
4. Removal: The infected mesh or prosthetic material is meticulously removed from the abdominal tissue.
5. Cleaning: The surrounding infected tissue may also be debrided or cleaned to remove any remaining sources of infection.
6. Closure: The incision is closed using sutures or staples.
7. Dressing: The surgical site is then covered with a sterile dressing.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity and extent of the infection.

Setting

This procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon: Performs the removal procedure.
• Anesthesiologist: Manages anesthesia.
• Surgical Nurses/Assistants: Assist the surgeon and monitor the patient.

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Injury to surrounding organs or tissues
• Anesthesia-related risks (e.g., reactions or complications)
• Recurrence of infection
• Delayed healing or poor wound closure

Benefits

• Resolution of chronic or recurrent infections
• Relief from persistent pain and discomfort
• Improvement in overall abdominal wall function and healing

Recovery

• Hospital stay for monitoring, typically 1-3 days.
• Pain management with prescribed medications.
• Instructions on wound care and activity restrictions.
• Follow-up appointments for assessment and suture removal.
• Full recovery may take several weeks, with gradual resumption of normal activities.

Alternatives

• Antibiotic therapy alone (less effective for chronic infections).
• Management with drainage procedures (temporary relief).
• Reoperation to replace the infected mesh (risk of recurrence).
• Patient-specific factors should be discussed with the healthcare provider to determine the best approach.

Patient Experience

• General anesthesia ensures a pain-free experience during the procedure.
• Postoperative soreness and discomfort, managed with pain medications.
• Detailed care instructions to prevent infection and promote healing.
• Gradual return to normal activities, with medical support and follow-up care.