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Treatment of mesh infection after inguinal hernia repair: 3-year experience with 120 patients

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Abstract

Purpose

Mesh infection is a devastating complication of sterile hernia repair surgery. This study was performed to assess the short- and long-term outcomes following treatment for mesh infection after inguinal hernia repair.

Methods

This single-center retrospective study included all patients who developed mesh infection after inguinal hernia repair from January 2018 to December 2020. Patient demographics, mesh infection characteristics, microbiology, features of surgery, short- and long-term outcomes, and follow-up data were analyzed.

Results

In total, 120 patients (8 women, 112 men; mean age, 54.4 years; mean body mass index, 24.8 kg/m2) were treated for mesh infection. The cultures were positive in 88 patients; 62.5% of these were positive for Staphylococcus aureus. Laparoscopic exploration was performed in 108 patients. Seventy patients underwent complete removal of infected mesh, and 50 underwent partial removal. During the short-term follow-up, 11 patients developed a minor wound infection and were treated with dressings and antibiotics, 1 developed a wound infection requiring debridement, 30 developed seromas, and 3 developed hematomas that did not require surgical intervention. During the mean follow-up of 39.1 months, 4 patients developed hernia recurrence, 2 experienced chronic pain, and 23 developed recurrent infection requiring reoperation in the partial mesh removal group (in contrast, only 4 patients in the complete mesh removal group developed recurrent infection, with a statistically significant difference).

Conclusion

The outcome of mesh infection after inguinal hernia repair treated by mesh removal is satisfactory. Systematic individualized treatment by experienced experts based on the patient’s previous repair technique, implanted mesh, and physical condition is recommended.

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Data availability

Qualitative interview data will not be shared in order to protect the identity of the study participants.

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Acknowledgements

We thank Angela Morben, DVM, ELS, from Liwen Bianji (Edanz) (www.liwenbianji.cn) for editing the English text of a draft of this manuscript.

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Authors and Affiliations

  1. Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, 5 Jingyuan Road, Shijingshan District, Beijing, 100043, China

    Zhenyu Zou, Jinxin Cao, Yilin Zhu, Qiuyue Ma & Jie Chen

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  1. Zhenyu Zou
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  2. Jinxin Cao
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Correspondence to Jie Chen.

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Zou, Z., Cao, J., Zhu, Y. et al. Treatment of mesh infection after inguinal hernia repair: 3-year experience with 120 patients. Hernia 27, 927–933 (2023). https://doi.org/10.1007/s10029-022-02702-x

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  • DOI: https://doi.org/10.1007/s10029-022-02702-x

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