Abstract
Background
Groin sepsis requiring mesh removal is said to be a rare complication of tension-free inguinal hernioplasty. Furthermore, late-onset deep-seated prosthetic infection seems to be an unexpected complication. The aim of this study was to report our experience on late mesh infection occurring years after open hernia repair.
Methods
Between 1998 and 2005, 1,452 patients (954 men), median age 64 years (range 19–89) underwent groin hernioplasty using a tension-free polypropylene mesh technique. Five patients (0.35%) appeared with late mesh infection (between 2 and 4.5 years postoperatively). The patients’ records were retrospectively reviewed for the purpose of this study. Antibiotic prophylaxis had been given in the five patients, while none of them had a prior history of wound infection.
Results
The patients were re-operated and the meshes were removed. Pus was found in three patients and Staphylococcus aureus was isolated in one. There was no hernia recurrence and none of the patients had chronic groin pain for a period of 6–44 months postoperatively.
Conclusion
From the results of this study, it appears that late-onset deep-seated prosthetic mesh infection is an important complication which has been rarely reported upon. Its true incidence is yet to be established. Late graft infection does not seem to correlate to neither the administration or not of antibiotic prophylaxis, nor to the presence or not of previous superficial wound infection. Furthermore, graft infection does not seem to correlate to neither the type of mesh inserted, nor to the fixation material. With the increasing use of synthetic materials for primary and recurrent hernia repair, the number of patients presenting with late mesh infections is likely to increase.
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References
Fawole AS, Chaparala RP, Ambrose NS (2005) Fate of the inguinal hernia following removal of infected prosthetic mesh. Hernia 10(1):58–61
Taylor SG, O’Dwyer PJ (1999) Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 86(4):562–565
Sanchez-Manuel FJ, Seco-Gil JL (2004) Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev 18(4):CD003769
Stephenson BM (2003) Complications of open groin hernia repair. Surg Clin North Am 83(5):1255–1278
Mann DV, Prout J, Havranek E, Gould S, Darzi A (1998) Late-onset deep prosthetic infection following mesh repair of inguinal hernia. Am J Surg 176(1):12–14
Usher FC (1963) Hernia repair with knitted polypropylene mesh. Surg Gynecol Obstet 117:139–140
Arnaud JP, Eloy R, Adloff M, Grenier JF (1977) Critical evaluation of prosthetic materials in repair of abdominal wall hernias. Am J Surg 133(3):338–345
Bellon JM, Bujan I, Contreras L, Juranto F (1994) Macrophage response to experimental implantation of polypropylene prostheses. Eur Surg Res 26(1):46–53
Dougherty SH (1986) Implant infection. In: von Recum AF (ed) Handbook of biomaterials evaluation. Macmillan, New York, pp 276–289
Gilbert AI, Felton LL (1993) Infection of inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 177(2):126–130
Bauer JJ, Salky BA, Gelernt IM, Kreel I (1987) Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE). Ann Surg 206(6):765–769
Foschi D, Corsi F, Cellerino P, Trabucchi A, Trabucchi E (1998) Late rejection of the mesh after laparoscopic hernia repair. Surg Endosc 12(5):455–457
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Delikoukos, S., Tzovaras, G., Liakou, P. et al. Late-onset deep mesh infection after inguinal hernia repair. Hernia 11, 15–17 (2007). https://doi.org/10.1007/s10029-006-0131-1
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DOI: https://doi.org/10.1007/s10029-006-0131-1