The Effect of the Use of Synthetic Mesh Soaked in Antibiotic Solution on the Rate of Graft Infection in Ventral Hernias: A Prospective Randomized Study

Abstract

Wound infections and seroma formations are important problems in ventral hernia repair operations using synthetic mesh grafts. The aim of this study was to investigate the effect of the use of synthetic mesh soaked in vancomycin solution on the rate of graft infection. The total number of subjects was 52. The subjects were randomized into 2 groups using a software program. Group 1 (n = 26) was the control group. In group 2 (n = 26), synthetic mesh was soaked in a Vancomycin solution before it was implanted. The patients were compared with respect to demographic characteristics and preoperative, intraoperative, and postoperative variables. There were no significant differences between the groups with respect to the available variables. Seroma development was significantly more common in group 2 (P < 0.041). Three patients (5.7%) developed superficial wound infection, and 9 (17%) developed surgical site infection 2-type wound-site infection. No significant difference was found between the groups in terms of infection. The use of synthetic mesh soaked in vancomycin solution had no beneficial effects on the rate of wound-site infection. Future randomized, controlled, large-scale studies using the same mesh and suture types, and meshes soaked in larger spectrum antibiotics are needed.

Experimental Grounds for Using Collagen-Based Anti-Adhesion Barrier Coated with Biocides for Prevention of Abdominal Surgical Infection

“…Given that bacterial adhesion to the surface of the implanted natural polymer which becomes a source of nutrient substrates for microorganisms is a key stage of biofilm formation, coating of the implant with an antimicrobial drug is a promising strategy to prevent implant-associated infection [13,18]. In clinical practice of some countries, it has been proposed to impregnate or put an allosteric implant in an antibiotic solution just before use [24][25][26]. However, the efficacy of this method in reducing the risk of bacterial complications when using anti-adhesion barriers made of natural fibers has not been proved.…”

Prevention of patch infection after abdominal external hernia repair

“…The specific mechanism underlying patch infection remains unclear to date because of its complex origin. Factors that increase the risk for patch infection include patients, chronic obstructive pneumonia, diabetes, morbid obesity, malnutrition, history of coronary heart disease, smoking history, immunodeficiencies, and American Society of Anesthesiologists score ≥3 [3][4][5][6]. In addition, recent studies have discovered other factors related to the occurrence of patch infection.…”

“…However, a prospective study of 395 patients in recent years has shown that the preoperative prophylactic use of cefazoline does not reduce the incidence of infection [14]. In addition, immersion treatment with vancomycin before the patch implantation cannot significantly improve the postoperative infection rate [5]. In view of the relatively low incidence of patch infection and bacterial resistance, routine application of antibiotics to prevent infection before hernia repair is not advisable.…”

To the question about a possibility of use ultra-light titanium- containing mesh in abdominal wall repair in contaminated fields (experimental study)

“…Имеется ограниченное число клинических и экспериментальных исследований по данному вопросу. Указанными вопросами активно занимаются ведущие клиники разных стран [1,3,[8][9][10]31].…”