Related Experiment Video
Updated: Mar 17, 2026
Use of a Rat Model to Study Ventral Abdominal Hernia Repair
Published on: October 2, 2017
Oral, intestinal, and skin bacteria in ventral hernia mesh implants
Odd Langbach1,2, Anne Karin Kristoffersen3, Emnet Abesha-Belay3
1Department of Gastroenterologic Surgery, Akershus University Hospital, University of Oslo, Lørenskog, Norway.
Background:
In ventral hernia surgery, mesh implants are used to reduce recurrence. Infection after mesh implantation can be a problem and rates around 6-10% have been reported. Bacterial colonization of mesh implants in patients without clinical signs of infection has not been thoroughly investigated. Molecular techniques have proven effective in demonstrating bacterial diversity in various environments and are able to identify bacteria on a gene-specific level.
Objective:
The purpose of this study was to detect bacterial biofilm in mesh implants, analyze its bacterial diversity, and look for possible resemblance with bacterial biofilm from the periodontal pocket.
Methods:
Thirty patients referred to our hospital for recurrence after former ventral hernia mesh repair, were examined for periodontitis in advance of new surgical hernia repair. Oral examination included periapical radiographs, periodontal probing, and subgingival plaque collection. A piece of mesh (1×1 cm) from the abdominal wall was harvested during the new surgical hernia repair and analyzed for bacteria by PCR and 16S rRNA gene sequencing. From patients with positive PCR mesh samples, subgingival plaque samples were analyzed with the same techniques.
Results:
A great variety of taxa were detected in 20 (66.7%) mesh samples, including typical oral commensals and periodontopathogens, enterics, and skin bacteria. Mesh and periodontal bacteria were further analyzed for similarity in 16S rRNA gene sequences. In 17 sequences, the level of resemblance between mesh and subgingival bacterial colonization was 98-100% suggesting, but not proving, a transfer of oral bacteria to the mesh.
Conclusion:
The results show great bacterial diversity on mesh implants from the anterior abdominal wall including oral commensals and periodontopathogens. Mesh can be reached by bacteria in several ways including hematogenous spread from an oral site. However, other sites such as gut and skin may also serve as sources for the mesh biofilm.
Insights
Bacterial biofilm, including oral pathogens, is common on ventral hernia mesh implants, even without infection signs. This suggests bacteria can spread from oral sites to the mesh, potentially impacting recurrence.
Area of Science:
- Microbiology
- Surgical Innovation
- Medical Diagnostics
Background:
- Ventral hernia repair frequently uses mesh implants to minimize recurrence.
- Mesh infection rates range from 6-10%, but asymptomatic bacterial colonization is understudied.
- Molecular techniques offer sensitive detection of bacterial diversity and identification.
Purpose of the Study:
- To detect and analyze bacterial biofilm diversity on explanted mesh implants.
- To investigate potential similarities between mesh biofilm and periodontal bacterial communities.
- To explore bacterial sources contributing to mesh colonization.
Main Methods:
- Thirty patients undergoing revision ventral hernia repair provided mesh samples.
- Pre-operative oral examinations included radiographs, probing, and subgingival plaque collection.
- Polymerase chain reaction (PCR) and 16S rRNA gene sequencing identified bacteria in mesh and plaque samples.
Main Results:
- Bacterial taxa, including oral commensals, periodontopathogens, and skin/enteric bacteria, were found in 66.7% of mesh samples.
- High sequence similarity (98-100%) was observed between mesh and subgingival bacteria in 17 cases.
- Findings suggest a potential transfer of oral bacteria to the mesh implant.
Conclusions:
- Mesh implants harbor diverse bacteria, including oral commensals and periodontopathogens.
- Bacteria can reach mesh implants via hematogenous spread from oral sites.
- The gut and skin are also potential sources for mesh biofilm formation.
