A Comparison of the Incidence of Early Postoperative Infections between Patients Using Synthetic Mesh and Those Undergoing Traditional Pelvic Reconstructive Surgical Procedures

Abstract

R e c e i ve d Ju ly 2 , 2 0 1 2 ; A c c e p t e d A p r i l 8 , 2 0 1 3 . Key words: Febrile morbidity -Pelvic organ prolapse -Postoperative infectionsSepsis -Synthetic polypropylene meshAbstract: New mesh-related complications such as erosion, etc., can result from abnormal postoperative healing due to surgical site infection. The aim of our study was to compare systemic inflammatory responses and the incidence of early infectious complications after reconstructive surgery using synthetic mesh and after traditional vaginal wall repair. In this prospective observational study 99 women with symptomatic pelvic organ prolapse were included; 55 women underwent traditional repair and 44 repair using mesh. After the procedure infectious complications were monitored. The patients who underwent reconstructive Republic, and surgery using mesh material were more likely to have febrile morbidity in the postoperative period than the patients who had been treated with traditional repair (p=0.031); there was a higher incidence of combination febrile morbidity with elevated C-reactive protein (CRP) > 50 mg/l; p=0.046, and a higher incidence of CRP increase over 30 mg/l; p=0.005. Reconstructive procedures using synthetic mesh are accompanied by a higher incidence of early post-operative infectious complications. This study was supported by the Grant Agency of the Ministry of Health of the Czech IntroductionPelvic organ prolapse is a common problem affecting up to 50% of parous women (Subak et al., 2001). Not all of them are symptomatic (Olsen et al., 1997;Baessler and Maher, 2006), and the risk of requiring surgery for prolapse is 11-12% in women reaching 79 years of age (Olsen et al., 1997). For a long time traditional pelvic reconstruction surgical procedures were the only ones available. The longterm efficiency of those procedures varied, and re-operation rates of nearly 30% have been reported by Olsen et al. (1997), with a risk of recurrence of up to 45% according to Valaitis and Stanton (1994) and Kohli et al. (1998). This may be one of the reasons why synthetic meshes were introduced to pelvic reconstructive surgery. However, these new surgical procedure have brought with them new mesh-related complications such as erosion, pain syndrome, etc. as described by Bako and Dhar (2009). Some of these complications -erosion, shrinkage and abnormal pain -can result from abnormal postoperative healing due to surgical site infection.The vagina contains more microorganisms than any other site in the body except the bowel (Lamont and Haynes, 2008). Surgical procedures resulting in the opening of the vagina will result in contamination of normally sterile sites by bacteria that are normally resident in the vagina. Infection and inflammation depends on a mixture of surgical and host-related factors. When mesh material is used this decreases the size of the bacterial inoculum, which can induce postoperative infection.The aim of our study was to compare immediate inflammatory reaction and the incidence of infectious complications afte...

Current Questions of Diagnosis and Treatment of Patients With Peritoneal Adhesive Disease

“…According to some аuthors, the presence of adhesions is a cоntraindication for laparoscopy and the risk of its usе when other methods unjustified. With the аdvent of new technologies in endоscopic surgery and the devеlopment of safe methods of lapаroscopic approach in terms of relax-ation , as wеll as with the use of ultrаsound to visualize the possibilities of the method vistsеroparietal adhesions increased significаntly decreased and the number of cоmplications [21,22].…”