Surgical Repair With Free Fascia Lata Graft in Patients at Risk of Surgical Site Infection: A Case Series

Abstract

Background: When anatomic structures are excised so widely that the resulting defect cannot be closed directly during an operation, reconstruction of the defect is necessary. Prosthetic mesh is often used to reconstruct large defects because it is readily available and technically easy to use. However, the use of prosthetic material is contraindicated in cases of concomitant contamination due to the risk of mesh infection. We describe our experience of surgical repair using an autologous free fascia lata graft in 5 patients at risk of such infection. Methods: The procedure was performed for incisional hernia repair in 4 patients and reconstruction of the diaphragm after cytoreduction of recurrent ovarian cancer in 1. All patients underwent other concomitant procedures associated with contamination, such as colorectal resection, and these patients were included in a retrospective chart review. Results: Wound-related morbidity was observed in 1 patient whose drain culture was positive. This infection was resolved conservatively. No postoperative wound events required removal of the fascia graft, and there was no hernia occurrence during follow-up. Conclusion: Based on our clinical experience, we conclude that surgical repair using a free fascia lata graft is safe and effective, especially in patients with a risk of bacterial contamination.