Mesh infection after abdominal wall reconstruction is a complex and costly problem.
Preventing this problem in the first place is paramount; based on available evidence we present the risk factors and measures to prevent such an infection. When it occurs, the treatment of infected mesh spans a wide spectrum of options starting with mesh preservation and antibiotic coverage to a more aggressive surgical debridement, mesh explantation, and repeat reconstruction. Specifically, we assess the impact of mesh type and wound classification at the time of original repair and how they affect decision in the handling of a subsequent mesh infection. This chapter covers the various treatment strategies available to the surgeon taking into consideration patient risk factors, mesh types, and wound status.
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Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012;16(2):179–83.CrossRefPubMedGoogle Scholar
Carbonell AM, Cris CN, Cobb WS, Novitsky YW, Rosen MJ. Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg. 2013;217(6):991–8.CrossRefPubMedGoogle Scholar
Itani KMF, Rosen M, Vargo D, Awad SS, Denoto III G, Butler CE. Prospective study of single-stage repair of contaminated hernias using a biologic porcine tissue matrix: the RICH study. Surgery. 2012;152(3):498–505.CrossRefPubMedGoogle Scholar
Trunzo JA, Ponsky JL, Jin J, Williams CP, Rosen MJ. A novel approach for salvaging infected prosthetic mesh after ventral hernia repair. Hernia. 2009;13(5):545–9.CrossRefPubMedGoogle Scholar
Stremitzer S, Bachleitner-Hofmann T, Gradl B, Gruenbeck M, Bachleitner-Hoffman B, Mittlboeck M, Bergmann M. Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations. World J Surg. 2010;34(7):1702–9.CrossRefPubMedGoogle Scholar
Sabbagh C, Verhaeghe P, Brehant O, Browet F, Garriot B, Regimbeau JM. Partial removal of infected parietal meshes is a safe procedure. Hernia. 2012;16(4):445–9.CrossRefPubMedGoogle Scholar
Sanchez V, Abi-Haidar YE, Itani KMF. Mesh infection in ventral incisional hernia repair: incidence, contributing factors, and treatment. Surg Infect. 2011;12(3):205–10.CrossRefGoogle Scholar
Cevasco M, Itani KMF. Ventral hernia repair with synthetic, composite and biologic mesh: characteristics, indications and infection profile. Surg Infect. 2012;13(4):209–15.CrossRefGoogle Scholar
Hawn MT, Gray SH, Snyder CW, Graham LA, Finan KR, Vick CC. Predictors of mesh explantation after incisional hernia repair. Am J Surg. 2011;202(1):28–33.CrossRefPubMedGoogle Scholar