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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Safety of prosthetic mesh hernia repair in contaminated fields
Alfredo M Carbonell1, William S Cobb
1Division of Minimal Access and Bariatric Surgery, Department of Surgery, Hernia Center, Greenville Health System, University of South Carolina School of Medicine - Greenville, 701 Grove Road, Greenville, SC 29605, USA.
Abstract:
For years, surgical dictum has posited that permanent synthetic mesh is contraindicated in the repair of a hernia in a contaminated field. Numerous investigators, however, have demonstrated the acceptably low morbidity associated with the use of heavy-weight polypropylene mesh in clean-contaminated and contaminated fields. Recently, experience utilizing more modern, light-weight polypropylene mesh constructs in contaminated fields has grown considerably. The time has come to critically reevaluate the unfounded fear of utilizing permanent synthetic mesh in contaminated fields, as we will review the data speaking to the safety of mesh in these contaminated fields.
Insights
Permanent synthetic mesh is safe for hernia repair in contaminated surgical fields. Recent studies show modern mesh has low complication rates, challenging old surgical beliefs.
Area of Science:
- Surgical innovation
- Hernia repair techniques
- Biomaterials in surgery
Background:
- Traditional surgical practice advises against permanent synthetic mesh in contaminated fields.
- Previous research indicated acceptable safety for heavy-weight polypropylene mesh in contaminated settings.
- Emerging data suggests modern, light-weight mesh is also viable.
Purpose of the Study:
- To critically reevaluate the contraindication of permanent synthetic mesh in contaminated fields.
- To review existing data on the safety of mesh use in contaminated hernia repair.
- To challenge the historical fear associated with mesh in compromised surgical environments.
Main Methods:
- Literature review of studies on mesh hernia repair in contaminated fields.
- Analysis of morbidity and complication rates associated with synthetic mesh.
- Comparison of outcomes between heavy-weight and light-weight polypropylene mesh.
Main Results:
- Evidence supports the safety of both heavy-weight and light-weight polypropylene mesh in contaminated fields.
- Morbidity rates are acceptably low with modern mesh constructs.
- The historical contraindication appears to be an unfounded fear.
Conclusions:
- Permanent synthetic mesh can be safely used in contaminated fields for hernia repair.
- Modern mesh technology has improved safety profiles, making it a viable option.
- Surgical practice should evolve to incorporate mesh in contaminated hernia repairs based on current evidence.
