A very late infection of an abdominal mesh following a pedicled TRAM flap harvest.

Pedicled transverse rectus abdominis myocutaneous (TRAM) flap is still a common procedure for breast reconstruction. To lessen the incidence of abdominal-wall abnormalities, the donor-site defect in the transverse rectus abdominis muscle is generally repaired with a prosthetic mesh. This carries the well-known risks of foreign-body implantation, the most serious of which is infection. We report here a case of a 46-year-old patient who presented with an infected mesh 6.5 years after pedicled transverse rectus abdominis myocutaneous (TRAM)-flap breast reconstruction, requiring subsequent removal of the mesh. This is the latest recorded presentation of an abdominal prosthetic mesh infection in the English literature. The onset of late mesh infection could be related to a transient systemic infection and bacteraemia.