Antibacterial Mesh

Yurko, Yuliya; McDeavitt, Kathleen; Kumar, Rohan; Martin, Terri R.; Prabhu, Ajita S.; Lincourt, Amy E.; Vertegel, Alexey; Heniford, B. Todd

doi:10.1177/1553350611410716

Cited by 15 publications

(6 citation statements)

References 32 publications

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“…Some investigators proposed that although only a few patients will benefit from the antibiotic prophylaxis, antibiotics may still be beneficial due to the considerable morbidity derived from a potential prosthesis infection [30]. Other interventions currently examined to reduce the risk of mesh infections include the concomitant placement of antibiotic-impregnated collagen tampons [54], meshes impregnated with older (i.e., cefazolin, silver/ chlorhexidine, vancomycin) [55][56][57][58] or novel antimicrobial agents against S. aureus (lysostaphin) [59][60][61][62], the use of surgical drapes [36], and topical application of povidoneiodine solution (betadine) [63].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Mesh‐related Infections After Hernia Repair Surgery: A Meta‐analysis of Cohort Studies

et al. 2011

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Mesh infection, although infrequent, is a devastating complication of mesh hernioplasties. The aim of this study was to systematically review and synthesize the available evidence on risk factors for synthetic mesh infection after hernioplasty. A systematic search was performed in PubMed and Scopus databases. The extracted data were synthesized with the methodology of meta-analysis. We identified six eligible studies that reported on 2,418 mesh hernioplasties. The crude mesh infection rate was 5%. Statistically significant risk factors were smoking (risk ratio [RR] = 1.36 [95% confidence interval (CI): 1.07, 1.73]; 1,171 hernioplasties), American Society of Anesthesiologists (ASA) score ≥3 (RR = 1.40 [1.15, 1.70]; 1,682 hernioplasties), and emergency operation (RR = 2.46 [1.56, 3.91]; 1,561 hernioplasties). Also, mesh infections were significantly correlated with patient age (weighted mean difference [WMD] = 2.63 [0.22, 5.04]; 2,364 hernioplasties), ASA score (WMD = 0.23 [0.08, 0.38]; 1,682 hernioplasties), and the duration of the hernioplasty (WMD = 44.92 [25.66, 64.18]; 833 hernioplasties). A trend toward higher mesh infection rates was observed in obese patients (RR = 1.41 [0.94, 2.11]; 2,243 hernioplasties) and in patients operated on by a resident (in contrast to a consultant; RR = 1.18 [0.99, 1.40]; 982 hernioplasties). Mesh infections usually resulted in mesh removal, and common pathogens included Staphylococcus spp., Enterococcus spp., and gram-negative bacteria. Patient age, ASA score, smoking, and the duration and emergency setting of the operation were found to be associated with the development of synthetic mesh infection. The heterogeneity of the available evidence should be taken under consideration. Prospective studies with a meticulous follow-up are warranted to further investigate mesh-related infections.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Mesh‐related Infections After Hernia Repair Surgery: A Meta‐analysis of Cohort Studies

et al. 2011

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“…In this regard, coating meshes for hernia repair with antiseptics could be a favorable strategy to prevent prosthetic mesh infection, avoiding the bacterial adhesion to the material surface. Mesh soaking in antiseptics prior to implantation is an easy and fast procedure which could reduce the negative side effects associated with the extended use of antibiotics [ 25 , 26 ]. In the present work we have evaluated the short-time performance of two compounds with antibacterial activity to soak PP meshes in a rabbit model of Sa infection.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the extended or inadequate use of antibiotic prophylaxis can lead to several adverse effects [ 23 ] and promote the occurrence of novel antibiotic resistances [ 24 ], so the local administration of antiseptic solutions is becoming more frequent. The utilization of antibacterial agents or antiseptics could avoid the development of novel resistances [ 25 ] and their local/topical application could reduce the systemic toxicity caused by antibiotic treatment [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Preclinical Bioassay of a Polypropylene Mesh for Hernia Repair Pretreated with Antibacterial Solutions of Chlorhexidine and Allicin: An In Vivo Study

et al. 2015

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IntroductionProsthetic mesh infection constitutes one of the major complications following hernia repair. Antimicrobial, non-antibiotic biomaterials have the potential to reduce bacterial adhesion to the mesh surface and adjacent tissues while avoiding the development of novel antibiotic resistance. This study assesses the efficacy of presoaking reticular polypropylene meshes in chlorhexidine or a chlorhexidine and allicin combination (a natural antibacterial agent) for preventing bacterial infection in a short-time hernia-repair rabbit model.MethodsPartial hernia defects (5 x 2 cm) were created on the lateral right side of the abdominal wall of New Zealand White rabbits (n = 21). The defects were inoculated with 0.5 mL of a 106 CFU/mL Staphylococcus aureus ATCC25923 strain and repaired with a DualMesh Plus antimicrobial mesh or a Surgipro mesh presoaked in either chlorhexidine (0.05%) or allicin-chlorhexidine (900 μg/mL-0.05%). Fourteen days post-implant, mesh contraction was measured and tissue specimens were harvested to evaluate bacterial adhesion to the implant surface (via sonication, S. aureus immunolabeling), host-tissue incorporation (via staining, scanning electron microscopy) and macrophage response (via RAM-11 immunolabeling).ResultsThe polypropylene mesh showed improved tissue integration relative to the DualMesh Plus. Both the DualMesh Plus and the chlorhexidine-soaked polypropylene meshes exhibited high bacterial clearance, with the latter material showing lower bacterial yields. The implants from the allicin-chlorhexidine group displayed a neoformed tissue containing differently sized abscesses and living bacteria, as well as a diminished macrophage response. The allicin-chlorhexidine coated implants exhibited the highest contraction.ConclusionsThe presoaking of reticular polypropylene materials with a low concentration of chlorhexidine provides the mesh with antibacterial activity without disrupting tissue integration. Due to the similarities found with the antimicrobial DualMesh Plus material, the chlorhexidine concentration tested could be utilized as a prophylactic treatment to resist infection by prosthetic mesh during hernia repair.

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“…Antimicrobial meshes can be made by dipping/soaking, plasma surface functionalization, plasma-induced graft polymerization [216] (see Figure 3). The antibiotic dipping/soaking method [217][218][219][220], antiseptics [221] and enzymes [222,223] dissolved in a liquid solution (usually aqueous) that are physically adsorbed onto the mesh. This technique, while useful, has not demonstrated clinical superiority over systemic antibiotic therapy.…”

Section: Antimicrobial Meshes and Their Fabrication Methodsmentioning

confidence: 99%

Prosthetic Meshes for Hernia Repair: State of Art, Classification, Antimicrobial Approaches, and Fabrication Methods

Serrano‐Aroca¹,

Pous‐Serrano²

2021

Preprint

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Worldwide, hernia repair represents one of the most frequent surgical procedures encompassing a global market valued at several billion dollars. This type of surgery usually requires the implantation of a mesh that needs the appropriate chemical, physical and biological properties for the type of repair. This review thus presents a description of the types of hernias, current hernia repair methods, and the state of the art of prosthetic meshes for hernia repair providing the most important meshes used in clinical practice by surgeons working in this area classified according to their biological or chemical nature, morphology and whether bioabsorbable or not. We emphasise the importance of surgical site infection in herniatology, how to deal with this microbial problem, and we go further into the future research lines on the production of advanced antimicrobial meshes to improve hernia repair and prevent microbial infections, including multidrug-resistant strains. A great deal of progress has been made in this biomedical field in the last decade. However, we are still far from an ideal antimicrobial mesh that can also provide excellent integration to the abdominal wall, mechanical performance, low visceral adhesion and minimal inflammatory or foreign body reactions, among many other problems.

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Antibacterial Mesh

Abstract: Lysostaphin had superior antibacterial activity following adsorption to mesh.

Cited by 15 publications

References 32 publications

Risk Factors for Mesh‐related Infections After Hernia Repair Surgery: A Meta‐analysis of Cohort Studies

Risk Factors for Mesh‐related Infections After Hernia Repair Surgery: A Meta‐analysis of Cohort Studies

Preclinical Bioassay of a Polypropylene Mesh for Hernia Repair Pretreated with Antibacterial Solutions of Chlorhexidine and Allicin: An In Vivo Study

Prosthetic Meshes for Hernia Repair: State of Art, Classification, Antimicrobial Approaches, and Fabrication Methods

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