BACKGROUND: Prosthetic mesh is employed routinely in the treatment of ventral and parastomal hernias, but its use can lead to major complications, including infection, extrusion, and fistula. Bacterial biofilms have been posited to play a role in mesh-related infection, but although bacteria have been noted to form biofilms on mesh surfaces in vitro, they have never been visualized directly in biofilms on mesh recovered from patients experiencing infectious complications. METHODS: Five patients who developed complications after ventral hernia repair with prosthetic mesh were operated on again. Explanted mesh was examined for biofilm with confocal laser scanning microscopy (CLSM) and fluorescence in situ hybridization (FISH). In two cases, a novel molecular assay (the Ibis T5000) was used to characterize the biofilm-forming bacteria. RESULTS: The CLSM examination demonstrated adherent biofilms on mesh surfaces in all five patients. Biofilms also were noted on investing fibrous tissue. The FISH study was able to discriminate between bacterial species in polymicrobial biofilms. In two patients the Ibis T5000 detected more species of constituent biofilm bacteria than did standard culture. Removal of the mesh and reconstruction with autologous tissues or biologic materials resolved the presenting complaints in all cases. CONCLUSION: Bacterial biofilms should be considered an important contributor to the pathology and complications associated with prosthetic mesh implanted in the abdominal wall. If biofilms are present, complete removal of the mesh and repair of the resulting defect without alloplastic materials is an effective intervention.
BACKGROUND: Prosthetic mesh is employed routinely in the treatment of ventral and parastomal hernias, but its use can lead to major complications, including infection, extrusion, and fistula. Bacterial biofilms have been posited to play a role in mesh-related infection, but although bacteria have been noted to form biofilms on mesh surfaces in vitro, they have never been visualized directly in biofilms on mesh recovered from patients experiencing infectious complications. METHODS: Five patients who developed complications after ventral hernia repair with prosthetic mesh were operated on again. Explanted mesh was examined for biofilm with confocal laser scanning microscopy (CLSM) and fluorescence in situ hybridization (FISH). In two cases, a novel molecular assay (the Ibis T5000) was used to characterize the biofilm-forming bacteria. RESULTS: The CLSM examination demonstrated adherent biofilms on mesh surfaces in all five patients. Biofilms also were noted on investing fibrous tissue. The FISH study was able to discriminate between bacterial species in polymicrobial biofilms. In two patients the Ibis T5000 detected more species of constituent biofilm bacteria than did standard culture. Removal of the mesh and reconstruction with autologous tissues or biologic materials resolved the presenting complaints in all cases. CONCLUSION: Bacterial biofilms should be considered an important contributor to the pathology and complications associated with prosthetic mesh implanted in the abdominal wall. If biofilms are present, complete removal of the mesh and repair of the resulting defect without alloplastic materials is an effective intervention.
Authors: John William Costerton; James Christopher Post; Garth D Ehrlich; Fen Z Hu; Rachael Kreft; Laura Nistico; Sandeep Kathju; Paul Stoodley; Luanne Hall-Stoodley; Gerhard Maale; Garth James; Nick Sotereanos; Patrick DeMeo Journal: FEMS Immunol Med Microbiol Date: 2011-01-18
Authors: L Nistico; R Kreft; A Gieseke; J M Coticchia; A Burrows; P Khampang; Y Liu; J E Kerschner; J C Post; S Lonergan; R Sampath; F Z Hu; G D Ehrlich; P Stoodley; L Hall-Stoodley Journal: J Clin Microbiol Date: 2011-02-09 Impact factor: 5.948
Authors: Scot E Dowd; Yan Sun; Patrick R Secor; Daniel D Rhoads; Benjamin M Wolcott; Garth A James; Randall D Wolcott Journal: BMC Microbiol Date: 2008-03-06 Impact factor: 3.605
Authors: O Guillaume; B Pérez Kohler; R Fortelny; H Redl; F Moriarty; R G Richards; D Eglin; A Petter Puchner Journal: Hernia Date: 2018-08-28 Impact factor: 4.739
Authors: Massimo Sartelli; Xavier Guirao; Timothy C Hardcastle; Yoram Kluger; Marja A Boermeester; Kemal Raşa; Luca Ansaloni; Federico Coccolini; Philippe Montravers; Fikri M Abu-Zidan; Michele Bartoletti; Matteo Bassetti; Offir Ben-Ishay; Walter L Biffl; Osvaldo Chiara; Massimo Chiarugi; Raul Coimbra; Francesco Giuseppe De Rosa; Belinda De Simone; Salomone Di Saverio; Maddalena Giannella; George Gkiokas; Vladimir Khokha; Francesco M Labricciosa; Ari Leppäniemi; Andrey Litvin; Ernest E Moore; Ionut Negoi; Leonardo Pagani; Maddalena Peghin; Edoardo Picetti; Tadeja Pintar; Guntars Pupelis; Ines Rubio-Perez; Boris Sakakushev; Helmut Segovia-Lohse; Gabriele Sganga; Vishal Shelat; Michael Sugrue; Antonio Tarasconi; Cristian Tranà; Jan Ulrych; Pierluigi Viale; Fausto Catena Journal: World J Emerg Surg Date: 2018-12-14 Impact factor: 5.469
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