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Purpose <p>Mesh infection after ventral hernia repair remains rare, but often necessitates mesh removal. This study evaluated the short- and long-term outcomes of a strategy involving explantation of the infected mesh and insertion of a long-term absorbable mesh in acute (AMI) and chronic mesh infections (CMI).</p> Methods <p>A retrospective study was performed in two tertiary centers (01.01.2017–31.12.2024). All consecutive patients with ventral mesh infection who underwent mesh explantation followed by placement of a long-term absorbable poly-4-hydroxybutyrate mesh were included. Primary endpoint was hernia recurrence rate. AMI was defined as mesh infection within 90 postoperative days.</p> Results <p>Twenty-nine patients were included: 14 AMI/15 CMI. Meshes were intraperitoneal in 9/14 (64%) AMI and in 13/15 (87%) CMI patients.&#xa0;Twelve (86%) and 13 patients (87%) had a new mesh implanted in the retromuscular space in the AMI and CMI groups, respectively. Four (28%) and 3 patients (21%) needed posterior component separations in the AMI and CMI groups.&#xa0;Median hospital stays were 10 (5–15) and 7 days (5–13) in both groups. Nine patients in each group (64%/60%) developed postoperative complications. Hernia recurrence rates were 3/14 (21%) and 0 in the AMI and CMI groups (mean follow-up 17 months). One mesh had to be explanted in the AMI group (0 in the CMI group).</p> Conclusions <p>The presented strategy was associated with high short-term morbidity, but good long-term results, with low mesh explantation and hernia recurrence rates. A longer follow-up and inclusion of more patients is required to assess the risk of hernia recurrence and reinfection with greater hindsight.</p>

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Mesh removal and ventral hernia repair with long-term absorbable mesh in case of mesh infection

  • 期刊论文

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  • 发表日期：

    2025年10月14日

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  • Gaëtan-Romain Joliat,
  • Guillaume Passot,
  • Benoit Romain

摘要

Purpose

Mesh infection after ventral hernia repair remains rare, but often necessitates mesh removal. This study evaluated the short- and long-term outcomes of a strategy involving explantation of the infected mesh and insertion of a long-term absorbable mesh in acute (AMI) and chronic mesh infections (CMI).

Methods

A retrospective study was performed in two tertiary centers (01.01.2017–31.12.2024). All consecutive patients with ventral mesh infection who underwent mesh explantation followed by placement of a long-term absorbable poly-4-hydroxybutyrate mesh were included. Primary endpoint was hernia recurrence rate. AMI was defined as mesh infection within 90 postoperative days.

Results

Twenty-nine patients were included: 14 AMI/15 CMI. Meshes were intraperitoneal in 9/14 (64%) AMI and in 13/15 (87%) CMI patients. Twelve (86%) and 13 patients (87%) had a new mesh implanted in the retromuscular space in the AMI and CMI groups, respectively. Four (28%) and 3 patients (21%) needed posterior component separations in the AMI and CMI groups. Median hospital stays were 10 (5–15) and 7 days (5–13) in both groups. Nine patients in each group (64%/60%) developed postoperative complications. Hernia recurrence rates were 3/14 (21%) and 0 in the AMI and CMI groups (mean follow-up 17 months). One mesh had to be explanted in the AMI group (0 in the CMI group).

Conclusions

The presented strategy was associated with high short-term morbidity, but good long-term results, with low mesh explantation and hernia recurrence rates. A longer follow-up and inclusion of more patients is required to assess the risk of hernia recurrence and reinfection with greater hindsight.