Optimal management of mesh infection: Evidence and treatment options
Mesh reinforcement is generally considered the standard of care in ventral hernia repair. Infection is a common complication following ventral hernia repair. Infection extending to the mesh is a complex problem. Knowledge of current treatment strategies is necessary for surgeons performing abdominal...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | International Journal of Abdominal Wall and Hernia Surgery |
| Subjects: | |
| Online Access: | http://www.herniasurgeryjournal.org/article.asp?issn=2589-8736;year=2018;volume=1;issue=2;spage=42;epage=49;aulast=Arnold |
| _version_ | 1818936567299833856 |
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| author | Michael R Arnold Angela M Kao Korene K Gbozah B Todd Heniford Vedra A Augenstein |
| author_facet | Michael R Arnold Angela M Kao Korene K Gbozah B Todd Heniford Vedra A Augenstein |
| author_sort | Michael R Arnold |
| collection | DOAJ |
| description | Mesh reinforcement is generally considered the standard of care in ventral hernia repair. Infection is a common complication following ventral hernia repair. Infection extending to the mesh is a complex problem. Knowledge of current treatment strategies is necessary for surgeons performing abdominal wall reconstruction. A comprehensive literature review was performed of current literature to assess risk factors and treatment options for mesh infection. Modifiable risk factors for mesh infections include active smoking, poorly controlled diabetes mellitus, abdominal skin or wound issues, and obesity. Operative factors that increase the risk of mesh infection include prior hernia repair, enterotomy and contamination of the surgical field. Of the synthetic meshes, lightweight polypropylene has the highest likelihood of salvage. Patients that are current smokers, those with other synthetic mesh types, and those infected with MRSA are rarely salvaged. Following excision of infected mesh, multi-staged abdominal wall reconstruction can be considered. Biologic or biosynthetic mesh is recommended when repairing incisional hernias following excision of infected mesh and likely represent the patient's best chance at a definitive hernia repair. Wound VAC-assisted delayed primary closure should be considered in higher-risk patients. Mesh infection is a complex complication that is commonly encountered by surgeons performing hernia repair. Prevention through patient optimization should be performed whenever appropriate. However, when patients develop a mesh infection, most will require complete mesh excision and recurrent hernia repair. |
| first_indexed | 2024-12-20T05:38:07Z |
| format | Article |
| id | doaj.art-373f0f336e4743509348841f307db6b9 |
| institution | Directory Open Access Journal |
| issn | 2589-8078 |
| language | English |
| last_indexed | 2024-12-20T05:38:07Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | International Journal of Abdominal Wall and Hernia Surgery |
| spelling | doaj.art-373f0f336e4743509348841f307db6b92022-12-21T19:51:31ZengWolters Kluwer Medknow PublicationsInternational Journal of Abdominal Wall and Hernia Surgery2589-80782018-01-0112424910.4103/ijawhs.ijawhs_16_18Optimal management of mesh infection: Evidence and treatment optionsMichael R ArnoldAngela M KaoKorene K GbozahB Todd HenifordVedra A AugensteinMesh reinforcement is generally considered the standard of care in ventral hernia repair. Infection is a common complication following ventral hernia repair. Infection extending to the mesh is a complex problem. Knowledge of current treatment strategies is necessary for surgeons performing abdominal wall reconstruction. A comprehensive literature review was performed of current literature to assess risk factors and treatment options for mesh infection. Modifiable risk factors for mesh infections include active smoking, poorly controlled diabetes mellitus, abdominal skin or wound issues, and obesity. Operative factors that increase the risk of mesh infection include prior hernia repair, enterotomy and contamination of the surgical field. Of the synthetic meshes, lightweight polypropylene has the highest likelihood of salvage. Patients that are current smokers, those with other synthetic mesh types, and those infected with MRSA are rarely salvaged. Following excision of infected mesh, multi-staged abdominal wall reconstruction can be considered. Biologic or biosynthetic mesh is recommended when repairing incisional hernias following excision of infected mesh and likely represent the patient's best chance at a definitive hernia repair. Wound VAC-assisted delayed primary closure should be considered in higher-risk patients. Mesh infection is a complex complication that is commonly encountered by surgeons performing hernia repair. Prevention through patient optimization should be performed whenever appropriate. However, when patients develop a mesh infection, most will require complete mesh excision and recurrent hernia repair.http://www.herniasurgeryjournal.org/article.asp?issn=2589-8736;year=2018;volume=1;issue=2;spage=42;epage=49;aulast=Arnoldherniainfectionmanagementmeshtreatment |
| spellingShingle | Michael R Arnold Angela M Kao Korene K Gbozah B Todd Heniford Vedra A Augenstein Optimal management of mesh infection: Evidence and treatment options International Journal of Abdominal Wall and Hernia Surgery hernia infection management mesh treatment |
| title | Optimal management of mesh infection: Evidence and treatment options |
| title_full | Optimal management of mesh infection: Evidence and treatment options |
| title_fullStr | Optimal management of mesh infection: Evidence and treatment options |
| title_full_unstemmed | Optimal management of mesh infection: Evidence and treatment options |
| title_short | Optimal management of mesh infection: Evidence and treatment options |
| title_sort | optimal management of mesh infection evidence and treatment options |
| topic | hernia infection management mesh treatment |
| url | http://www.herniasurgeryjournal.org/article.asp?issn=2589-8736;year=2018;volume=1;issue=2;spage=42;epage=49;aulast=Arnold |
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