Evidence for Replacement of an Infected Synthetic by a Biological Mesh in Abdominal Wall Hernia Repair

Frontiers in Surgery
Agneta MontgomeryFerdinand Köckerling

Abstract

The incidence of deep infection using a synthetic mesh in inguinal hernia repair is low and reported to be well below 1%. This is in contrast to incisional hernia surgery where the reported incidence is 3% respective 13% comparing laparoscopic to open mesh repair reported in a Cochrane review. Main risk factors were long operation time, surgical site contamination, and early wound complications. An infected mesh can be preserved using conservative treatment were negative pressure wound therapy (VAC(®)) could play an important role. If strategy fails, the mesh needs to be removed. This review aims to look at evidence for situations were a biological mesh would work as a replacement of a removed infected synthetic mesh. A literature search of the Medline database was performed using the PubMed search engine. Twenty publications were found relevant for this review. For studies reviewed three options are presented: removal of the infected synthetic mesh alone, replacement with either a new synthetic or a new biological mesh. Operations were all performed at specialist centers. Removal of the mesh alone was an option limited to inguinal hernias. In ventral/incisional hernias, the use of a biological mesh for replacement resulted in ...Continue Reading

References

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Jan 22, 2003·The Cochrane Database of Systematic Reviews·K McCormackUNKNOWN EU Hernia Trialists Collaboration
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Citations

Oct 1, 2011·The Journal of Infection·Vishal GuptaSatish Phatak
Feb 2, 2018·Hernia : the Journal of Hernias and Abdominal Wall Surgery·F KöckerlingN J Smart
Feb 27, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·B Pérez-KöhlerJ M Bellón
Oct 28, 2017·Frontiers in Surgery·Ekaterini Christina TampakiGregory Kouraklis
Mar 23, 2018·Frontiers in Surgery·Evangelos P Misiakos, Konstantinos George Tsalis
Sep 4, 2016·Hernia : the Journal of Hernias and Abdominal Wall Surgery·B Pérez-KöhlerJ M Bellón
Dec 20, 2018·World Journal of Emergency Surgery : WJES·Massimo SartelliFausto Catena

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