Staged approach to chronic mesh infection following hernia repair: a single-center experience
摘要
To investigate the outcomes of a two-staged approach involving mesh explantation surgery in patients with chronic mesh infection (CMI) following hernia repair.
MethodsA retrospective review of patients who underwent mesh explantation for CMI after ventral and inguinal hernia repair (2011–2019) using electronic database records.
ResultsSixty-four patients (41 M, 23 F) included in this study had a mean age and BMI of 46.5 and 26.7, respectively. The most commonly isolated organism was Staphylococcus aureus (23.5%). Complete mesh explantation was performed in 41 patients, partial in 17, and debridement in 5 others. One patient underwent single-stage hernia mesh repair using biological mesh. Among the other 63, 22 (35%) had recurrent hernia after mesh explantation (mean follow-up: 4 years), 14 underwent hernia mesh repair, and eight were lost to follow-up; 41 (65%) remained recurrence-free after mesh explantation over a mean follow-up of 4 years (SD +/- 2.18 years). The recurrence rate after mesh explantation was significantly lower in patients with inguinal hernias (16%, 4/25) than in those with ventral hernias (46.2%, 18/39; p = 0.046).
ConclusionChronic mesh infections following hernia repair pose a formidable challenge to surgeons. It is better handled at specialized centers. We suggest complete mesh explantation in such patients and staged repair in the event of a hernia recurrence.