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Mesh infection after inguinal hernia mesh repair
1Clinique Turin, 7-9, rue de Turin, 75008 Paris, France. hubert.johanet@gmail.com
Introduction:
Infection after repair of groin hernia is rare, even since the advent of mesh repair. The debate remains open about antibiotic prophylaxis.
Aim Of The Study:
Assess incidence of this kind of complication, determine criteria of diagnosis and strategy of therapy by examining the collective experience of 32 surgeons.
Method:
Fifty surgeons were asked to report their experience with mesh repair of inguinal hernias and specifically mesh infection. Diagnosis and therapy for each mesh infection were detailed.
Results:
Forty-five cases were reported in 38 patients who had undergone open or laparoscopic mesh repair. Diagnosis was straightforward and established at a variable delay after mesh insertion: 51% during the first postoperative month; 26% more than one year after the procedure. Infection cured in 33 patients after mesh removal, in one step in 14 cases, but after many attempts for conservative therapy in 19 cases; the mean delay to cure was 12.5 months. Visceral resections had to be associated with mesh removal in 13% of cases.
Conclusions:
This is the largest series of mesh infections after inguinal hernia repair reported in the literature. According to the evidence provided here, mesh removal appears to be the most appropriate treatment of this rare and serious complication.
Insights
Mesh infection after inguinal hernia repair is rare but serious. Prompt diagnosis and mesh removal are crucial for successful treatment, often requiring multiple attempts for complete cure.
Area of Science:
- Surgical Innovation
- Hernia Repair Techniques
- Infectious Disease in Surgery
Background:
- Surgical site infections following groin hernia repair using mesh are uncommon.
- The necessity and efficacy of antibiotic prophylaxis in mesh hernia repair remain debated.
- Mesh infection represents a rare but significant complication in hernia surgery.
Purpose of the Study:
- To evaluate the incidence of mesh infection after inguinal hernia repair.
- To establish diagnostic criteria for mesh infection.
- To determine optimal therapeutic strategies for mesh infection based on collective surgical experience.
Main Methods:
- A retrospective review of mesh infections following open or laparoscopic inguinal hernia repair was conducted.
- Data were collected from 50 surgeons, detailing their experiences with mesh repair and subsequent infections.
- Diagnostic methods and therapeutic interventions for each reported mesh infection were analyzed.
Main Results:
- Forty-five cases of mesh infection were reported in 38 patients.
- Diagnosis occurred at variable times post-implantation, with 51% within the first month and 26% over a year later.
- Mesh removal led to cure in 33 patients, with 14 requiring single-stage removal and 19 needing conservative therapy first; average cure time was 12.5 months. Visceral resections were needed in 13% of cases.
Conclusions:
- This study represents the largest reported series on mesh infections after inguinal hernia repair.
- Mesh removal is identified as the most effective treatment for this rare complication.
- Early diagnosis and surgical intervention are critical for managing mesh infections effectively.
