Postoperative Infection in Mesh Repair Hernias, Risk Factors and  Management

Hayder Mohammed Ali  Zainy

doi:10.48165/sajssh.2024.6101

Authors

Hayder Mohammed Ali Zainy M.B.Ch.B./F.I.C.M.S. (General surgery) at Safeer Al-Imam Al-Hussain Surgical Hospital. Karbala, Iraq.

DOI:

https://doi.org/10.48165/sajssh.2024.6101

Keywords:

Incisional hernia, Mesh-related infections, surgical site infection

Abstract

Background: A hernia occurs when a portion of the abdominal cavity's contents protrudes through a defect or weakness in the abdominal wall. Incisional hernias occur after surgery and are very common and challenging to repair. Mesh-related infections following incisional hernia repairs are significant complications with considerable morbidity. Aim of the Study: to describe our technique and management of patients with mesh related infection and offer a comprehensive review of surgical site infections following hernia surgery, focusing on the associated risk factors and management strategies. Methodology: a prospective interventional study that was conducted at Safeer Al-Imam Al Hussain Surgical Hospital, Imam Hussain Medical City, Zain Al-Abedin Surgical Hospital and Al-Kafeel Specialized Hospital / Karbalaa/ Iraq over 10 years (2014-2024). Forty patients with mesh infections post-incisional hernia repair were included. Data collected included demographic variables, risk factors, clinical variables, and treatment outcomes. Results: The study sample comprised 40 patients with a mean age of 52.3 years. Females comprised 32 (80%) of the patients. The infection resolved in 77.5% of patients with conservative treatment, while 22.5% required surgical mesh removal. Conclusions: Mesh-related infections after incisional hernia repair may occur as a complication after repair. Conservative treatment is often effective, but surgical removal is necessary for persistent infections. Addressing risk factors preoperatively may improve outcomes. Further research and refined techniques are needed to reduce infection rates and improve patient outcomes.

References

Ahmad, S. et al. (2007) ‘Conservative management of mesh site infection in ventral hernia repair’, Journal of Ayub Medical College Abbottabad, 19(4), pp. 75–77.

Al Quraini , A. N. H. A. (2024). Knowledge & Attitude among Parents of Children with Bronchial Asthma whom Attending Iraq Pediatric Hospital . South Asian Journal of Social Sciences and Humanities, 5(5), 26-40. https://doi.org/10.48165/sajssh.2024.5502

Arnold, M. R. et al. (2018) ‘Optimal management of mesh infection: evidence and treatment options’, International Journal of Abdominal Wall and Hernia Surgery, 1(2), pp. 42–49.

Bigliardi, P. L. et al. (2017) ‘Povidone iodine in wound healing: A review of current concepts and practices’, International Journal of Surgery, 44, pp. 260–268.

Borad, N. P. and Merchant, A. M. (2017) ‘The effect of smoking on surgical outcomes in ventral hernia repair: a propensity score matched analysis of the National Surgical Quality Improvement Program data’, Hernia, 21, pp. 855–867.

Bueno Garcia Reyes, P. and Hashim, H. (2020) ‘Mesh complications: best practice in diagnosis and treatment’, Therapeutic Advances in Urology, 12, p. 1756287220942993.

Dietz, U. A. et al. (2018) ‘The treatment of incisional hernia’, Deutsches Ärzteblatt International, 115(3), p. 31.

Falagas, M. E. and Kasiakou, S. K. (2005) ‘Mesh-related infections after hernia repair surgery’, Clinical microbiology and infection, 11(1), pp. 3–8.

Forbes, S. S. et al. (2009) ‘Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh’, Journal of British Surgery, 96(8), pp. 851–858.

Guillaume, O. et al. (2018) ‘Infections associated with mesh repairs of abdominal wall hernias: Are antimicrobial biomaterials the longed-for solution?’, Biomaterials, 167, pp. 15–31.

Jamal, . A. A. ., Hassan, S. A., Kadhim, B. M., & Muhammad, S. . O. F. (2024). Simple Closure and Rhomboid Flap Closure for Pilonidal Sinus Disease . South Asian Journal of Social Sciences and Humanities, 5(6), 1-12. https://doi.org/10.48165/sajssh.2024.5601

Kaoutzanis, C. et al. (2015) ‘Risk factors for postoperative wound infections and prolonged hospitalization after ventral/incisional hernia repair’, Hernia, 19, pp. 113–123.

Köckerling, F. (2019) ‘Recurrent incisional hernia repair—an overview’, Frontiers in Surgery, 6, 26.

Kokotovic, D., Bisgaard, T. and Helgstrand, F. (2016). ‘Long-term recurrence and complications associated with elective incisional hernia repair’, Jama, 316(15), 1575–1582.

Van der Linden, F. T. and Van Vroonhoven, T. (1988) ‘Long-term results after surgical correction of incisional hernia.’, The Netherlands Journal of Surgery, 40(5), pp. 127–129.

Mavros, M. N. et al. (2011) ‘Risk factors for mesh-related infections after hernia repair surgery: a meta-analysis of cohort studies’, World journal of surgery, 35, pp. 2389–2398.

Meagher, H., Clarke Moloney, M. and Grace, P. A. (2015) ‘Conservative management of mesh-site infection in hernia repair surgery: a case series’, Hernia, 19, pp. 231–237.

Musters, G. D. et al. (2015) ‘Local application of gentamicin in the prophylaxis of perineal wound infection after abdominoperineal resection: a systematic review’, World journal of surgery, 39(11), pp. 2786–2794.

Plymale, M. A. et al. (2020) ‘Costs and complications associated with infected mesh for ventral hernia repair’, Surgical infections, 21(4), pp. 344–349.

Rai, S. et al. (2023) ‘Hydrogen Peroxide: Its Use in an Extensive Acute Wound to Promote Wound Granulation and Infection Control–Is it Better Than Normal Saline?’, The International Journal of Lower Extremity Wounds, 22(3), pp. 563–577.

Sanchez, V. M., Abi-Haidar, Y. E. and Itani, K. M. F. (2011) ‘Mesh infection in ventral incisional hernia repair: incidence, contributing factors, and treatment’, Surgical infections, 12(3), pp. 205–210.

Sanders, D. L. and Kingsnorth, A. N. (2012) ‘The modern management of incisional hernias’, Bmj, 344.

Yetim, I. et al. (2010) ‘Effect of local gentamicin application on healing and wound infection in patients with modified radical mastectomy: a prospective randomized study’, Journal of International Medical Research, 38(4), pp. 1442–1447.

.