[Prosthetic infection after hernioplasty. Five years experience].

Abstract

INTRODUCTION Prosthesis infection is an infrequent but important complication in abdominal wall surgery. The aim of this study is to evaluate the incidence and risk factors for the infection of the prosthesis after hernia repair, as well as the treatment to apply. MATERIAL AND METHOD Between January 2002 and December 2006, we performed 1055 prosthetic hernia repairs: 761 inguinal hernias (72.1%), 74 umbilical hernias (7%) and 220 ventral hernias (20.9%). We prospectively analysed preoperative, intraoperative and postoperative variables, as well as the incidence of infection of surgical wound and of prosthesis. We used ASA classification for preoperative anaesthetic evaluation. RESULTS The overall percentage of infection of the prosthesis was 1.3%. Infection was observed in 11 repairs with polypropylene mesh (PPL), in 4 with PTFE mesh, and one case in combined mesh. Risk factors of mesh infection were: obesity (p=0.002), diabetes (p=0.020), the type of repair (p=0.047), emergency surgery (p=0.001), the type and size of mesh (p=0.003; p=0.007) and time of surgery >180 min (p<0.001). Seven of the 11 patients with infection of PPL prosthesis were resolved with conservative treatment, whereas all the cases with PTFE infection or mixed mesh needed removal to solve the problem. CONCLUSIONS Several factors are involved in producing a prosthesis infection. Whereas antibiotic treatment and surgical drainage of the infection can be sufficient in most PPL mesh infection, PTFE prostheses need to be removed prematurely in order to halt the infection process.

DOI: 10.1016/j.ciresp.2008.09.008

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@article{Lledo2009ProstheticIA, title={[Prosthetic infection after hernioplasty. Five years experience].}, author={Jos{\'e} Antonio Bueno Lledo and Yurena Sosa Quesada and Inmaculada Gomez I Gavara and Javier Vaqu{\'e} Urbaneja and Fernando Carbonell Tatay and Santiago Bonaf{\'e} Diana and Providencia Garc{\'i}a Pastor and Ricardo Baquero Valdelomar and Jos{\'e} Mir Pallard{\'o}}, journal={Cirugía española}, year={2009}, volume={85 3}, pages={158-64} }