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Study of mesh infection management following inguinal hernioplasty with an analysis of risk factors: a 10-year experience

  • H. Yang
  • Y. Xiong
  • J. ChenEmail author
  • Y. Shen
Original Article



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.


Mesh infection Risk factors Inguinal hernia repair Hernioplasty 


Authors’ contributions

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.

Ethical approval

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.

Informed consent

Inform consent was obtained from all individual participants included in this study.


  1. 1.
    Narkhede R, Shah NM, Dalal PR, Mangukia C, Dholaria S (2015) Postoperative mesh infection-still a concern in laparoscopic era. Indian J Surg 77:322–326. CrossRefGoogle Scholar
  2. 2.
    LeBlanc KA, Whitaker JM, Bellanger DE, Rhynes VK (2003) Laparoscopic incisional and ventral hernioplasty: lessons learned from 200 patients. Hernia 7:118–124. CrossRefGoogle Scholar
  3. 3.
    Cobb WS, Carbonell AM, Kalbaugh CL (2009) Infection risk of open placement of intraperitoneal composite mesh. Am Surg 75(9):762–767Google Scholar
  4. 4.
    Yang H, Liu Y, Chen J, Shen Y (2019) The management of mesh infection after laparoscopic inguinal hernia repair. Surg Laparosc Endosc Percutan Tech 29:40–42. CrossRefGoogle Scholar
  5. 5.
    McCormack K, Scott NW, Gdgo PM, Ross SJ, Grantdfg A (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1:CD001785. Google Scholar
  6. 6.
    Chowbey PK, Khullar R, Sharma A, Soni V, Baijal M, Garg N, Najma K (2015) Laparoscopic management of infected mesh after laparoscopic inguinal hernia repair. Surg Laparosc Endosc Percutan Tech 25:125–128. CrossRefGoogle Scholar
  7. 7.
    Sanchez VM, Abi-Haidar YE, Itani KM (2011) Mesh infection in ventral incisional hernia repair: incidence, contributing factors, and treatment. Surg Infect 12:205–210. CrossRefGoogle Scholar
  8. 8.
    Mavros MN, Athanasiou S, Alexiou VG, Mitsikostas PK, Peppas G, Falagas ME (2011) Risk factors for mesh-related infections after hernia repair surgery: a meta-analysis of cohort studies. World J Surg 35:2389–2398. CrossRefGoogle Scholar
  9. 9.
    Harrell AG, Novitsky YW, Kercher KW, Foster M, Burns JM, Kuwada TS, Heniford BT (2006) In vitro infectability of prosthetic mesh by methicillin-resistant Staphylococcus aureus. Hernia 10:120–124. CrossRefGoogle Scholar
  10. 10.
    Rosemar A, Angerås U, Rosengren A, Nordin P (2010) Effect of body mass index on groin hernia surgery. Ann Surg 252:397–401. CrossRefGoogle Scholar
  11. 11.
    Lledó JB, Quesada YS, Gavara IG, Urbaneja JV, Tatay FC, Diana SB, Pastor PG, Valdelomar RB, Pallardó JM (2009) Prosthetic infection after hernioplasty. Five years experience. Cir Esp 85:158–164. CrossRefGoogle Scholar
  12. 12.
    Taylor SG, O’Dwyer PJ (1999) Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 86:562–565. CrossRefGoogle Scholar
  13. 13.
    An YH, Friedman RJ (1998) Concise review of mechanisms of bacterial adhesion to biomaterial surfaces. J Biomed Mater Res 43:338–348.;2-B CrossRefGoogle Scholar
  14. 14.
    Jass J, Surman S, Walker JT (2005) Microbial biofilms in medicine. Wiley, ChichesterGoogle Scholar
  15. 15.
    Leid JG, Shirtliff ME, Costerton JW, Stoodley P (2002) Human leukocytes adhere to, penetrate, and respond to Staphylococcus aureus biofilms. Infect Immun 70:6339–6345. CrossRefGoogle Scholar
  16. 16.
    Tolino MJ, Tripoloni DE, Ratto R, Garcia MI (2009) Infections associated with prosthetic repairs of abdominal wall hernias: pathology, management and results. Hernia 13:631–637. CrossRefGoogle Scholar
  17. 17.
    Fawole AS, Chaparala RP, Ambrose NS (2006) Fate of the inguinal hernia following removal of infected prosthetic mesh. Hernia 10:58–61. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Hernia and Abdominal Wall SurgeryThe Capital Medical University Beijing Chaoyang HospitalBeijingChina

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