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Are late hernia mesh complications linked to Staphylococci biofilms?

P Patiniott1, A Jacombs2, L Kaul1,3

  • 1Surgery Department, The Queen Elizabeth Hospital and Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, Australia.

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|March 14, 2022
PubMed
Abstract

Insights

Bacterial biofilms on hernia meshes may cause surgical failure. This study found staphylococci biofilms in 95% of explanted meshes, suggesting a link to complications like chronic pain and recurrence.

Area of Science:

  • Microbiology
  • Surgical Innovation
  • Biomaterials Science

Background:

  • Bacterial biofilms are implicated in mesh-related infections following hernia repair surgery.
  • The role of biofilms in hernia repair failure, particularly in the absence of overt infection, requires further investigation.

Purpose of the Study:

  • To investigate the presence and composition of bacterial biofilms on explanted hernia meshes.
  • To explore the potential association between biofilms and negative outcomes in hernia repair, such as chronic pain, recurrence, and mesh shrinkage.

Main Methods:

  • Retrospective analysis of 20 explanted hernia meshes.
  • Detection of Staphylococcus aureus and coagulase-negative staphylococci biofilms using fluorescence in situ hybridization (FISH) and confocal laser scanning microscopy.
  • Identification of bacterial DNA using Staphylococcus aureus and Staphylococcus epidermidis specific PCR.

Main Results:

  • Bacterial biofilms were detected in 95% of explanted hernia mesh samples using combined FISH/microscopy and PCR.
  • Staphylococci biofilms were present in 75% of samples via microscopy and 85% via PCR.
  • S. aureus and S. epidermidis were commonly identified, often co-existing within the biofilms.

Conclusions:

  • Staphylococci biofilms are frequently found on explanted hernia meshes, even without signs of acute infection.
  • The presence of these biofilms may be associated with hernia repair failure and subsequent complications.
  • Undetected biofilm infections could be a contributing factor to chronic pain, mesh complications, and disease exacerbation after hernia repair.
Keywords:
BiofilmsChronic painHerniaImplant infectionMesh complicationMesh failureStaphylococcus aureus

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