Staged Salvage Repair of an Infected Canine Perineal Hernia after Mesh Herniorrhaphy Using Sacro-Ischial Sling Reconstruction: A Case Report

Wannasit Chantornvong; Bhumiphat Tanarattanapisith; Jitrapun Jirasakul; Chanchanok Sakulakkharavee; Maethinee Pititaweewat; Suwaporn Kittinoraseth; Wijit Sutthiprapa

Authors

Wannasit Chantornvong Parichart Suwinthawong Animal Hospital, 91 Khum Klao Road, Sansab, Minburi, Bangkok, 10510, Thailand
Bhumiphat Tanarattanapisith Parichart Suwinthawong Animal Hospital, 91 Khum Klao Road, Sansab, Minburi, Bangkok, 10510, Thailand
Jitrapun Jirasakul Parichart Suwinthawong Animal Hospital, 91 Khum Klao Road, Sansab, Minburi, Bangkok, 10510, Thailand
Chanchanok Sakulakkharavee Parichart Suwinthawong Animal Hospital, 91 Khum Klao Road, Sansab, Minburi, Bangkok, 10510, Thailand
Maethinee Pititaweewat Parichart Suwinthawong Animal Hospital, 91 Khum Klao Road, Sansab, Minburi, Bangkok, 10510, Thailand
Suwaporn Kittinoraseth Parichart Suwinthawong Animal Hospital, 91 Khum Klao Road, Sansab, Minburi, Bangkok, 10510, Thailand
Wijit Sutthiprapa Surgery Unit, Kasetsart University Veterinary Teaching Hospital, Bangkok, 10900, Thailand

Keywords:

Dog, Perineal hernia, Sacro-ischial sling, Mesh infection, Revision surgery

Abstract

Perineal hernia repair is difficult when infection involves a previous prosthetic reconstruction because infection control and durable pelvic support must both be achieved. This report describes staged management of a dog with postoperative mesh infection after repair of a contralateral perineal hernia, followed by delayed salvage sacro-ischial sling (SS) reconstruction. A 12-year-old intact male Thai Bangkaew dog weighing 16.9 kg was initially presented with a right caudal perineal hernia and later developed a contralateral left caudal perineal hernia after right-sided mesh repair and castration. The left-sided hernia was repaired using mesh, but purulent discharge developed postoperatively. Management consisted of wound opening, drainage, serial dressing changes, culture and susceptibility testing, antimicrobial adjustment according to culture results and clinical response, and eventual mesh removal with loose skin closure to maintain drainage. After infection control, delayed revision was performed using an 80-lb polyethylene leader-line SS and an active drain. Recovery after revision surgery was uneventful. Follow-up radiographs showed stable metallic crimp position without evidence of construct displacement, and no recurrence was observed through the last follow-up examination at 644 days after the initial left-sided mesh repair. The clinical contribution of this case is the demonstration that staged infection control, infected implant removal, and delayed SS reconstruction may be a feasible salvage strategy in selected dogs with infected perineal hernia repairs.

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