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Surgical management of infected abdominal wall mesh: an analysis using the American Hernia Society Quality

C L Devin1, M A Olson2, L Tastaldi3

  • 1Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospital, 1100 Walnut Street-Suite 500, Philadelphia, PA, 19107, USA.

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|January 5, 2021
PubMed
Abstract

Insights

Incisional hernia repair with infected mesh removal showed no significant difference in short-term complications between complete repair (CR) and partial repair (PR) strategies. Both approaches offer comparable outcomes for managing infected abdominal mesh complications.

Area of Science:

  • Abdominal surgery
  • Hernia repair
  • Infectious disease management

Background:

  • Infected abdominal mesh presents a complex surgical challenge.
  • Management strategies for infected mesh removal and hernia repair vary.
  • Understanding outcomes of different repair techniques is crucial for patient care.

Purpose of the Study:

  • To examine management patterns and 30-day outcomes for infected mesh removal with concomitant incisional hernia repair.
  • To compare outcomes between complete repair (CR) and partial repair (PR) strategies.

Main Methods:

  • Retrospective analysis of patients undergoing infected mesh removal and incisional hernia repair from the American Hernia Society Quality Collaborative.
  • Defined CR as fascial closure with mesh; PR as fascial closure without mesh or no fascial closure with mesh.
  • Compared 30-day outcomes including complications, surgical site infections, and readmissions between CR and PR groups.

Main Results:

  • 282 patients were analyzed: 136 in CR and 146 in PR.
  • Groups had similar comorbidities but differed in wound class and concomitant colorectal procedures.
  • No statistically significant differences were observed in length of stay, overall complications, surgical site infections, surgical site occurrences, or 30-day readmissions between CR and PR.

Conclusions:

  • Incisional hernia repair following infected mesh removal can be performed with either complete or partial repair techniques.
  • Short-term outcomes and complication rates are comparable between CR and PR strategies in the presence of infection.
  • These findings support flexibility in surgical approach based on individual patient and wound characteristics.
Keywords:
Chronic infectionHernia repairIncisional herniaMesh infection

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