BACKGROUND: Mesh infection after abdominal hernia repair is a devastating complication that affects general and plastic surgeons alike. The purpose of this study was 3-fold: (1) to determine current evidence for treatment of infected abdominal wall mesh via systematic review of literature, (2) to analyze our single-institution experience with treatment of infected mesh patients, and (3) to establish a framework for how to approach this complex clinical problem. METHODS: Literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, followed by single-institution retrospective analysis of infected mesh patients. RESULTS: A total of 3565 abstracts and 92 full-text articles were reviewed. For qualitative and quantitative assessment, articles were subdivided on the basis of treatment approach: "conservative management," "excision of mesh with primary closure," "single-stage reconstruction," "immediate staged repair," and "repair in contaminated field." Evidence for each treatment approach is presented. At our institution, most patients (40/43) were treated by excision of infected mesh and single-stage reconstruction with biologic mesh. When the mesh was placed in a retrorectus or underlay fashion, 21.4% rate of hernia recurrence was achieved. Bridged repairs were highly prone to recurrence (88.9%; P = 0.001), but the bridging biologic mesh seemed to maintain domain and potentially contribute to a more effective repair in the future. Of the patients who underwent additional ("secondary") repairs after recurrence, 75% were eventually able to achieve "hernia-free" state. CONCLUSIONS: This study reviews the literature and our single-institution experience regarding treatment of infected abdominal wall mesh. Framework is developed for how to approach this complex clinical problem.
BACKGROUND: Mesh infection after abdominal hernia repair is a devastating complication that affects general and plastic surgeons alike. The purpose of this study was 3-fold: (1) to determine current evidence for treatment of infected abdominal wall mesh via systematic review of literature, (2) to analyze our single-institution experience with treatment of infected mesh patients, and (3) to establish a framework for how to approach this complex clinical problem. METHODS: Literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, followed by single-institution retrospective analysis of infected mesh patients. RESULTS: A total of 3565 abstracts and 92 full-text articles were reviewed. For qualitative and quantitative assessment, articles were subdivided on the basis of treatment approach: "conservative management," "excision of mesh with primary closure," "single-stage reconstruction," "immediate staged repair," and "repair in contaminated field." Evidence for each treatment approach is presented. At our institution, most patients (40/43) were treated by excision of infected mesh and single-stage reconstruction with biologic mesh. When the mesh was placed in a retrorectus or underlay fashion, 21.4% rate of hernia recurrence was achieved. Bridged repairs were highly prone to recurrence (88.9%; P = 0.001), but the bridging biologic mesh seemed to maintain domain and potentially contribute to a more effective repair in the future. Of the patients who underwent additional ("secondary") repairs after recurrence, 75% were eventually able to achieve "hernia-free" state. CONCLUSIONS: This study reviews the literature and our single-institution experience regarding treatment of infected abdominal wall mesh. Framework is developed for how to approach this complex clinical problem.
Authors: S Levy; D Moszkowicz; T Poghosyan; A Beauchet; M -M Chandeze; K Vychnevskaia; F Peschaud; J -L Bouillot Journal: Hernia Date: 2018-05-23 Impact factor: 4.739
Authors: Phoebe B McAuliffe; Abhishek A Desai; Ankoor A Talwar; Robyn B Broach; Jesse Y Hsu; Joseph M Serletti; Tiange Liu; Yubing Tong; Jayaram K Udupa; Drew A Torigian; John P Fischer Journal: Ann Surg Date: 2022-07-15 Impact factor: 13.787
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
Authors: F Köckerling; N N Alam; S A Antoniou; I R Daniels; F Famiglietti; R H Fortelny; M M Heiss; F Kallinowski; I Kyle-Leinhase; F Mayer; M Miserez; A Montgomery; S Morales-Conde; F Muysoms; S K Narang; A Petter-Puchner; W Reinpold; H Scheuerlein; M Smietanski; B Stechemesser; C Strey; G Woeste; N J Smart Journal: Hernia Date: 2018-01-31 Impact factor: 4.739
Authors: C Stabilini; B East; R Fortelny; J-F Gillion; R Lorenz; A Montgomery; S Morales-Conde; F Muysoms; M Pawlak; W Reinpold; M Simons; A C de Beaux Journal: Hernia Date: 2020-05-15 Impact factor: 4.739