[Conservative management of hernia mesh infection]

Standard management of infected mesh advocates its removal, but this often results in a larger hernia than at the time of original repair. In this article we describe a novel approach to manage conservatively an infected prosthetic mesh.

Mesh infection rate at our institution was 1%. We describe 3 cases (inguinal, ventral and parastomal hernias) that presented prosthetic mesh infections. All the cases were satisfactorily managed with a conservative approach, consisting in wound opening and pressurized wound irrigation with gentamicin (80mg/8hours) and intravenous infusion of Amoxicilin/Clavulanic acid (875mg+125mg/8hours) during 7 days, achieving sterile cultures of the mesh surface in all the cases. A 3rd intention closure of the wound was performed. There is no clinical evidence of recurrent infection in any case.

Conservative management of mesh infection, including drainage, antibiotic irrigation and wound closure, is a potential alternative to mesh removal.