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Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome
S Petersen1, G Henke, M Freitag
1Department of General and Abdominal Surgery, General Hospital Dresden-Friedrichstadt, Teaching Hospital University Dresden, Germany. petersen-sv@khdf.de
Objective:
To evaluate the incidence of prosthetic infection in incisional hernia repairs, to determine whether there are any factors associated with prosthetic infection and to describe the clinical outcome.
Design:
Retrospective clinical study.
Setting:
Teaching hospital, Germany.
Subjects:
121 consecutive patients who underwent incisional hernia repair in our department from December 1994 to December 1999.
Intervention:
Hernia repair by implantation of an alloplastic prosthesis by the Stoppa-Rives technique.
Main Outcome Measures:
Postoperative deep prosthetic infection and associated factors.
Results:
All 121 patients had the mesh implanted in the subfascial plane, 77 had a polypropylene mesh (Prolene) (64%), 7 had a polyester mesh (Mersilene) (6%), and 37 patients had a expanded polytetrafluoroethylene patch (ePTFE, Gore-Tex) (31%). Postoperatively the mesh became infected in 8 patients (7%), a mean of 4.5 months (range 0.5-16) after hernia repair. All three infected ePTFE patches had to be removed whereas drainage was sufficient treatment for the infected polypropylene and polyester meshes.
Conclusion:
Once a mesh infection is verified adequate drainage seems to be sufficient for polypropylene and polyester meshes but ePTFE patches should be removed.