Related Experiment Video
Updated: Oct 28, 2025
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Short-Term Outcomes Following Removal of Infected Hernia Mesh
Christine Tung1, Junko Ozao-Choy1, Dennis Y Kim1
1Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
Abstract:
There are limited studies regarding outcomes of replacing an infected mesh with another mesh. We reviewed short-term outcomes following infected mesh removal and whether placement of new mesh is associated with worse outcomes. Patients who underwent hernia repair with infected mesh removal were identified from 2005 to 2018 American College of Surgeons-National Surgical Quality Improvement Program database. They were divided into new mesh (Mesh+) or no mesh (Mesh-) groups. Bivariate and multivariate logistic regression analyses were used to compare morbidity between the two groups and to identify associated risk factors. Of 1660 patients, 49.3% received new mesh, with higher morbidity in the Mesh+ (35.9% vs. 30.3%; P = .016), but without higher rates of surgical site infection (SSI) (21.3% vs. 19.7%; P = .465). Mesh+ had higher rates of acute kidney injury (1.3% vs. .4%; P = .028), UTI (3.1% vs. 1.3%, P = .014), ventilator dependence (4.9% vs. 2.4%; P = .006), and longer LOS (8.6 vs. 7 days, P < .001). Multivariate logistic regression showed new mesh placement (OR: 1.41; 95% CI: 1.07-1.85; P = .014), body mass index (OR: 1.02; 95% CI: 1.00-1.03; P = .022), and smoking (OR: 1.43; 95% CI: 1.05-1.95; P = .025) as risk factors independently associated with increased morbidity. New mesh placement at time of infected mesh removal is associated with increased morbidity but not with SSI. Body mass index and smoking history continue to contribute to postoperative morbidity during subsequent operations for complications.
Insights
Replacing infected mesh with new mesh increases patient morbidity but not surgical site infection rates. Factors like higher body mass index and smoking also contribute to postoperative complications.
Area of Science:
- Abdominal surgery
- Surgical innovation
- Hernia repair outcomes
Background:
- Limited data exists on outcomes of replacing infected surgical mesh.
- Incisional hernia repair often involves mesh, which can become infected.
- Understanding risks associated with re-mesh placement after infection is crucial.
Purpose of the Study:
- To evaluate short-term outcomes after infected mesh removal.
- To determine if placing new mesh during infected mesh removal is associated with worse outcomes.
- To identify risk factors for morbidity following infected mesh removal and re-implantation.
Main Methods:
- Retrospective review of 1660 patients from the 2005-2018 American College of Surgeons-National Surgical Quality Improvement Program database.
- Patients undergoing infected mesh removal were divided into new mesh (Mesh+) or no mesh (Mesh-) groups.
- Bivariate and multivariate logistic regression analyses were used to compare morbidity and identify risk factors.
Main Results:
- Nearly half (49.3%) of patients received new mesh; this group had higher overall morbidity (35.9% vs. 30.3%, P=.016).
- Rates of surgical site infection (SSI) were similar between groups (21.3% vs. 19.7%, P=.465).
- The new mesh group experienced higher rates of acute kidney injury, urinary tract infection, ventilator dependence, and longer hospital stays.
Conclusions:
- New mesh placement during infected mesh removal is linked to increased postoperative morbidity but not SSI.
- Higher body mass index and smoking are independent risk factors for increased morbidity in these patients.
- Careful consideration of re-mesh placement and patient risk factors is warranted after infected mesh removal.
