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World Journal of Surgery

, Volume 30, Issue 12, pp 2270–2278 | Cite as

The Analysis of Infection after Polypropylene Mesh Repair of Abdominal Wall Hernia

  • Arnolds JezuporsEmail author
  • Māris Mihelsons
Article

Abstract

Aim

The aim of the study was to evaluate the frequency of superficial and prosthetic mesh infection following polypropylene mesh repair of different abdominal wall hernia in individual patients and to analyze the manifestation, clinical process and outcomes in patients with prosthetic mesh infection.

Methods

This was a retrospective analysis of 375 patients with 423 implanted meshes for groin, femoral, umbilical, incisional and epigastric hernias, with a mean follow-up of 15 months (range: 3–73 months).

Results

The total superficial infection rate was 1.65% percnt;, and the rate of mesh infection was 0.94% percnt;. There were no statistically significant differences in prosthetic mesh infection between monofilament and multifilament meshes as well as between the different repair groups of hernias. The deep incisional surgical site infection after previous operation was established as a significant risk factor for prosthetic mesh infection in incisional hernia repair (P < 0.0001). Five cases of prosthetic mesh infection were presented and analyzed.

Conclusions

There is no correlation between the superficial and prosthetic mesh infection. There may be difficulties in determining mesh infection and to choose the right tactic. The reconvalescence in all patients with mesh infection was achieved only after removal of the infected mesh.

Keywords

Antibacterial Therapy Femoral Hernia Groin Hernia Incisional Hernia Repair Abdominal Wall Hernia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

This study was supported by the European Social Foundation.

References

  1. 1.
    Managram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection. Infect Control Hosp Epidemiol 1999;20:250–278CrossRefGoogle Scholar
  2. 2.
    Rios A, Rodríguez JM, Munitiz V, et al. Antibiotic prophylaxis in incisional hernia repair using a prosthesis. Hernia 2001;5:148–152PubMedCrossRefGoogle Scholar
  3. 3.
    Taylor EW, Duffy K, Lee K, et al. Surgical site infection after groin hernia repair. Br J Surg 2004;91:105–111PubMedCrossRefGoogle Scholar
  4. 4.
    Aufenacker TJ, van Geldere D, van Mesdag T, et al. The role of antibiotic prophylaxis in prevention of wound infection after Lichtenstein open mesh repair of primary inguinal hernia. Ann Surg 2004;240:955–961PubMedCrossRefGoogle Scholar
  5. 5.
    Kuzu MA, Hazinedaroğlu S, Dolalan S, et al. Prevention of surgical site infection after open prosthetic inguinal hernia repair: Efficacy of parenteral versus oral prophylaxis with amoxicillin-clavulanic acid in a randomized clinical trial. World J Surg 2005;29:794–799PubMedCrossRefGoogle Scholar
  6. 6.
    Biswas S. Elective inguinal hernia repair with mesh: Is there a need for antibiotic prophylaxis? A review. World J Surg 2005;29:830–836PubMedCrossRefGoogle Scholar
  7. 7.
    Aufenacker TJ, Koelemay MJ, Gouma DJ, et al. Systematic review and meta-analysis of the effectiveness of antibiotic prophylaxis in prevention of wound infection after mesh repair of abdominal wall hernia. Br J Surg 2006;93:5–10PubMedCrossRefGoogle Scholar
  8. 8.
    Mann DV, Prout J, Havranek E, et al. Late-onset deep prosthetic infection following mesh repair of inguinal hernia. Am J Surg 1998;176:12–14PubMedCrossRefGoogle Scholar
  9. 9.
    Taylor SG, O’Dwyer PJ. Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 1999;86:562–565PubMedCrossRefGoogle Scholar
  10. 10.
    Stephenson B. Complications of open groin hernia repairs. Surg Clin North Am 2003;83:1255–1278PubMedCrossRefGoogle Scholar
  11. 11.
    Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery. Clin Microbiol Infect 2005;11:3–8PubMedCrossRefGoogle Scholar
  12. 12.
    Avtan L, Avci C, Bulut T, et al. Mesh infections after laparoscopic inguinal hernia repair. Surg Laparosc Endosc 1997;7:192–195PubMedCrossRefGoogle Scholar
  13. 13.
    Foschi D, Corsi F, Cellerino P, et al. Late rejection of the mesh after laparoscopic hernia repair. Surg Endosc 1998;12:455–457PubMedCrossRefGoogle Scholar
  14. 14.
    Hofbauer C, Andersen PV, Juul P, et al. Late mesh rejection as a complication to transabdominal preperitoneal laparoscopic hernia repair. Surg Enosc 1998;12:1164–1165CrossRefGoogle Scholar
  15. 15.
    Ismail W, Agrawal A, Zia MI. Fate of chronic infected onlay mesh in groin wound. Hernia 2002;6:79–81PubMedCrossRefGoogle Scholar
  16. 16.
    Amid PK, Shulman AG, Lichtenstein IL, et al. Biomaterials for abdominal wall hernia surgery and principles of their applications. Langenbecks Arch Surg 1994;379:168–171Google Scholar
  17. 17.
    Demiter S, Geçim IE, Aydinuraz K, et al. Affinity of Staphylococcus epidermidis to various prosthetic graft materials. J Surg Res 2001;99:70–74CrossRefGoogle Scholar
  18. 18.
    Leber GE, Garb JL, Ajexander AI, et al. Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 1998;133:378–382PubMedCrossRefGoogle Scholar
  19. 19.
    Morris-Stiff GJ, Hughes LE. The outcomes of nonabsorbable mesh placed within the abdominal cavity: literature review and clinical experience. J Am Coll Surg 1998;186:352–367PubMedCrossRefGoogle Scholar
  20. 20.
    Costanza MJ, Heniford BT, Arca MJ, et al. Laparoscopic repair of recurrent ventral hernias. Am Surg 1998;64:1121–1127PubMedGoogle Scholar
  21. 21.
    Ramshaw BJ, Esartia P, Schwab J, et al. Comparison of laparoscopic and open ventral herniorrhaphy. Am Surg 1999;65:827–832PubMedGoogle Scholar
  22. 22.
    Heniford BT, Park A, Ramshaw BJ, et al. Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 2000;190:645–650PubMedCrossRefGoogle Scholar
  23. 23.
    Korenkov M, Paul A, Sauerland S, et al. Classification and surgical treatment of incisional hernia. Langenbecks Arch Surg 2001;386:65–73PubMedCrossRefGoogle Scholar
  24. 24.
    Berger D, Bientzle M, Müller A. Postoperative complications after laparoscopic incisional hernia repair. Surg Endosc 2002;16:1720–1723PubMedCrossRefGoogle Scholar
  25. 25.
    Post S, Weiss B, Willer M, et al. Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 2004;91:44–48PubMedCrossRefGoogle Scholar
  26. 26.
    Conze J, Kingsnorth AN, Flament JB, et al. Randomized clinical trial comparing lightweight composite mesh with polyester or polypropylene mesh for incisional hernia repair. Br J Surg 2005;92:1488–1493PubMedCrossRefGoogle Scholar
  27. 27.
    Paajanen H. A single-surgeon randomized trial comparing three composite meshes (lightweight or heavyweight polypropylene and Vypro II® mesh) on chronic pain after Lichtenstein hernia repair in local anaesthesia. ISW 2005, Durban, South Africa, Abstract ID 2346Google Scholar
  28. 28.
    Deysine M. Pathophysiology, prevention and management of prosthetic infections in hernia surgery. Surg Clin North Am 1998;78:1105–1115PubMedCrossRefGoogle Scholar
  29. 29.
    Matthews MR, Caruso DM, Tsujimura RB, et al. Ventral hernia synthetic mesh repair infected by Mycobacterium fortuitum. Am Surg 1999;65:1035–1037PubMedGoogle Scholar
  30. 30.
    Wantz GE, Chevrel JP, Flament JB, et al. Incisional hernia: the problem and the cure. J Am Coll Surg 1999;188:429–446CrossRefGoogle Scholar
  31. 31.
    Petersen S, Henke G, Freitag M, et al. Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome. Eur J Surg 2001;167:453–457PubMedCrossRefGoogle Scholar
  32. 32.
    Favole AS, Chaparala RPC, Ambrose NS. Fate of the inguinal hernia following removal of infected prosthetic mesh. Hernia 2006;10:58–61CrossRefGoogle Scholar
  33. 33.
    Stringer RA, Salameh JR. Mesh herniorrhaphy during elective colorectal surgery. Hernia 2005;9:26–28PubMedCrossRefGoogle Scholar
  34. 34.
    Carbonell AM, Matthews BD, Dreau D, et al. The susceptibility of prosthetic biomaterials to infection. Surg Endosc 2005;19:430–435PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  1. 1.Department of General Surgery, Latvian Maritime Medical HospitalUniversity of LatviaRiga

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