Outcome of the patients with chronic mesh infection following open inguinal hernia repair

Abstract

PurposeHernia repairs are the most common elective abdominal wall procedures performed by general surgeons. The use of a mesh has become the standard for hernia repair surgery. Herein, we discuss a management strategy for chronic mesh infections following open inguinal hernia repair with onlay prosthetic mesh.MethodsIn this study, 15 patients with chronic mesh infections following open inguinal hernia repairs were included. The medical records of these patients were retrospectively reviewed and information regarding presentation, type of previous hernia repair, type of mesh, operative findings and bacteriological examination results were obtained. In all cases, the infected mesh was removed completely and the patients were treated with antibiotic regimens and local wound care.ResultsFifteen mesh removals due to chronic infection were performed between January 2000 and March 2012. The mean interval of hernia repair to mesh removal was 49 months. All patients were followed up for a median period of 62 months (range, 16 to 115 months). In all patients, the infections were resolved successfully and none were persistent or recurrent. However, one patient developed recurrent hernia and one developed nerve injury.ConclusionChronic mesh infection following hernia repair mandates removal of the infected mesh, which rarely results in hernia recurrence.

Biocompatibility versus peritoneal mesothelial cells of polypropylene prostheses for hernia repair, coated with a thin silica/silver layer

“…As regards hernia prostheses, even if mesh infection is relatively rare, the most common bacteria adhering to them are Staphylococcus aureus and Staphylococcus epidermidis . This fact was mainly demonstrated by clinical studies and “ in vitro ” experiments, also showing that bacterial adhesion is affected by prosthesis chemical composition and morphology …”

“…This fact was mainly demonstrated by clinical studies and "in vitro" experiments, also showing that bacterial adhesion is affected by prosthesis chemical composition and morphology. [41][42][43]48,49 More recently, Ag nanoparticles have also been shown to inhibit, to varying extents, the growth and viability of certain microorganisms, possibly through the production of free radicals inducing membrane damage, or via the release of Ag 1 ions. 24,50 The mesh layer of CMC for hernia repair was thus coated with Ag/SiO 2 nanoclusters, in order to confer antibacterial properties without altering biocompatibility.…”

“…The antibacterial effect of coatings was evaluated by counting colony forming units (CFU), using the Staphylococcus aureus strain (ATCC 29213), one of the pathogenic strains most frequently involved in biomaterial‐associated infection development and in particular in mesh‐related infection . The mesh layer, either sputtered with Ag/SiO 2 or uncoated as control, was positioned in a multiwell plate, covered with 1 mL of bacterial broth containing approximately 5 × 10 5 CFU, and incubated for 24 h at 35°C.…”

“…The antibacterial effect of coatings was evaluated by counting colony forming units (CFU), using the Staphylococcus aureus strain (ATCC 29213), one of the pathogenic strains most frequently involved in biomaterial-associated infection development and in particular in mesh-related infection. [41][42][43] The mesh layer, either sputtered with Ag/SiO 2 or uncoated as control, was positioned in a multiwell plate, covered with 1 mL of bacterial broth containing approximately 5 3 10 5 CFU, and incubated for 24 h at 358C. The mesh was then gently washed in physiological sterile saline solution (0.9% NaCl) to remove bacterial cells not adhering to the surface, and vortexed in fresh physiological solution for 1 minute to detach bacteria adhering to the mesh.…”

A retrospective analysis of surgical treatment of mesh infection after repair of ventral hernia or defect

“…However, we must pay attention to the complications associated with prosthetic meshes, especially that of mesh infection. Once mesh infection occurs, it is very difficult to cure (Stremitzer et al, 2010;Sanchez et al, 2011;Akyol et al, 2013); the situation usually requires complete removal of the mesh and sometimes multiple surgical treatments. Furthermore, after infected mesh removal, the problem of abdominal wall reconstruction still exists.…”