A 65 year old patient undergoes a hernia repair surgery. He receives a polypropylene mesh implant that prevents hernia recurrence. The healing goes well, but four weeks after the surgery he develops fever and sense of discomfort at the surgery site. On a physical examination, there is skin redness and fluctuating mass (palpable mass filled with fluid) around the incision. The doctor suspects that mesh got infected and plans mesh removal surgery. 1) Describe the sequence of local events during wound healing after the implantation of the mesh. For each of the stages of the wound healing process, specify cells that are involved, their role(s), signal molecules that are involved, and their roles. 2) Which pathogen most likely caused the infection?
A 65 year old patient undergoes a hernia repair surgery. He receives a polypropylene mesh implant that prevents hernia recurrence. The healing goes well, but four weeks after the surgery he develops fever and sense of discomfort at the surgery site. On a physical examination, there is skin redness and fluctuating mass (palpable mass filled with fluid) around the incision. The doctor suspects that mesh got infected and plans mesh removal surgery.
1) Describe the sequence of local events during wound healing after the implantation of the mesh. For each of the stages of the wound healing process, specify cells that are involved, their role(s), signal molecules that are involved, and their roles.
2) Which pathogen most likely caused the infection?
3) After initiation of antibiotic treatment, the symptoms are resolved in two days and the patient stops taking antibiotic against the doctor's advise. Two weeks later, the mesh is removed and analyzed. It is found that a small area of the mesh is covered with a grayish-green slime that contains living bacteria. Further examination shows that these bacteria are resistant to the antibiotic that was given to the patient. Explain these findings. Discuss the mechanism of development of antibiotic resistance. Explain why taking antibiotic for 7 days would have reduced the risk of development of resistance.
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