Novel use of bromelain in the management of infected prosthetic surgical mesh after ventral hernia repair

• Main Authors: Ernest Cheng, Amit Sarkar, Sarah J Valle, David L Morris
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: International Journal of Abdominal Wall and Hernia Surgery
• Subjects: bromelain; complex abdominal wall; hernia mesh infection; infected seroma; ventral hernia repair
• Online Access: http://www.herniasurgeryjournal.org/article.asp?issn=2589-8736;year=2020;volume=3;issue=1;spage=34;epage=37;aulast=Cheng

Surgical mesh infections from ventral hernia repairs are common in obese patients. Definitive management includes the surgical removal of mesh; however, obese patients are often poor surgical candidates with limited therapeutic options. We report the case of a 64-year-old male with an abdominal wall seroma secondary to an infected surgical mesh. This was on a background of multiple abdominal wall reconstructions for previous strangulated ventral hernias. A nonoperative novel approach utilizing bromelain percutaneously in conjunction with antibiotics successfully resolved the infected seroma. The purpose of this case is to detail the potential clinical application of bromelain in surgical site infections involving surgical prosthesis. We illustrate the successful use of bromelain as a nonoperative alternative for abdominal infections or when all other surgical and conservative therapies have been exhausted.