Study of mesh infection management following inguinal hernioplasty with an analysis of risk factors: a 10-year experience
We present a review of our 10-year experience in managing patients with mesh infection following hernioplasty and analyze the occurrence of known predisposing factors.
We analyzed 392 cases of mesh infection treated at our center between 2007 and 2018 after a preoperative work-up. (Thirty-one patients underwent the primary hernia repair procedure at our hospital, whereas the others underwent the primary surgery at other local centers and were referred to our center.) The method of infected mesh removal (open or laparoscopic) was selected depending on the primary surgical approach. Open repair involved the excision of the mesh, infected tissue, and sinus (if present). The laparoscopic approach was used to identify the abscess, excise the mesh, and allow drainage into the preperitoneal space.
The operative course in all patients was uneventful. A second surgery to extract the residual mesh around the pubic bone was performed in 7 patients. Hernia recurred in 29 patients after mesh removal. The discharge culture results were positive in 193 patients. Of these, Staphylococcus spp. was identified as the causative organism in 126 patients. Risk factors for mesh infection, including obesity, smoking, and diabetes, were identified in 182 (46.5%), 154 (39.3%), and 35 (8.9%) patients, respectively.
It is recommended the approach of mesh removal is tailored as per the primary hernioplasty method. We analyzed the occurrence of risk factors for mesh infection in this study, but further studies are needed to develop a predictive model that is both internally and externally validated to evaluate the probability of mesh infection.
KeywordsMesh infection Risk factors Inguinal hernia repair Hernioplasty
HY wrote the manuscript. YX collected the data for this study. YS and JC supervised the study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study complied the current law of China.
Human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Inform consent was obtained from all individual participants included in this study.
- 3.Cobb WS, Carbonell AM, Kalbaugh CL (2009) Infection risk of open placement of intraperitoneal composite mesh. Am Surg 75(9):762–767Google Scholar
- 13.An YH, Friedman RJ (1998) Concise review of mechanisms of bacterial adhesion to biomaterial surfaces. J Biomed Mater Res 43:338–348. https://doi.org/10.1002/(SICI)1097-4636(199823)43:3%3C338:AID-JBM16%3E3.0.CO;2-B CrossRefGoogle Scholar
- 14.Jass J, Surman S, Walker JT (2005) Microbial biofilms in medicine. Wiley, ChichesterGoogle Scholar