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The analysis of infection after polypropylene mesh repair of abdominal wall hernia
Arnolds Jezupovs1, Arnolds Jezupors, Māris Mihelsons
1Department of General Surgery, Latvian Maritime Medical Hospital, University of Latvia, 23 Patversmes Street, Riga, 1005, Latvia. jezupovs@tvnet.lv [corrected]
Aim:
The aim of the study was to evaluate the frequency of superficial and prosthetic mesh infection following polypropylene mesh repair of different abdominal wall hernia in individual patients and to analyze the manifestation, clinical process and outcomes in patients with prosthetic mesh infection.
Methods:
This was a retrospective analysis of 375 patients with 423 implanted meshes for groin, femoral, umbilical, incisional and epigastric hernias, with a mean follow-up of 15 months (range: 3-73 months).
Results:
The total superficial infection rate was 1.65%, and the rate of mesh infection was 0.94%. There were no statistically significant differences in prosthetic mesh infection between monofilament and multifilament meshes as well as between the different repair groups of hernias. The deep incisional surgical site infection after previous operation was established as a significant risk factor for prosthetic mesh infection in incisional hernia repair (P < 0.0001). Five cases of prosthetic mesh infection were presented and analyzed.
Conclusions:
There is no correlation between the superficial and prosthetic mesh infection. There may be difficulties in determining mesh infection and to choose the right tactic. The reconvalescence in all patients with mesh infection was achieved only after removal of the infected mesh.
Insights
Superficial and prosthetic mesh infections after abdominal wall hernia repair are uncommon. Deep incisional surgical site infection is a risk factor for mesh infection, which requires mesh removal for recovery.
Area of Science:
- Surgical Innovation
- Infectious Disease
- Biomaterials Science
Background:
- Abdominal wall hernia repair frequently utilizes polypropylene mesh prostheses.
- Prosthetic mesh infection is a serious complication impacting patient outcomes.
- Understanding infection rates and risk factors is crucial for surgical best practices.
Purpose of the Study:
- To determine the incidence of superficial and prosthetic mesh infections after polypropylene mesh repair for various abdominal wall hernias.
- To analyze the clinical presentation, progression, and outcomes of patients who develop prosthetic mesh infections.
- To identify potential risk factors associated with prosthetic mesh infection.
Main Methods:
- Retrospective analysis of 375 patients undergoing hernia repair with 423 implanted polypropylene meshes.
- Follow-up duration ranged from 3 to 73 months, with a mean of 15 months.
- Inclusion criteria covered groin, femoral, umbilical, incisional, and epigastric hernias.
Main Results:
- Overall superficial infection rate was 1.65%; prosthetic mesh infection rate was 0.94%.
- No significant difference in mesh infection rates was observed between monofilament and multifilament meshes or hernia types.
- Previous deep incisional surgical site infection was a significant risk factor for mesh infection in incisional hernia repair (P < 0.0001).
Conclusions:
- Superficial and prosthetic mesh infections appear to be unrelated.
- Diagnosing mesh infection can be challenging, complicating treatment decisions.
- Complete resolution of mesh infection was consistently achieved only after surgical removal of the infected mesh.
