Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome

Abstract

Objective: To evaluate the incidence of prosthetic infection in incisional hernia repairs, to determine whether there are any factors associated with prosthetic infection and to describe the clinical outcome.

Design: Retrospective clinical study.

Setting: Teaching hospital, Germany.

Subjects: 121 consecutive patients who underwent incisional hernia repair in our department from December 1994 to December 1999.

Intervention: Hernia repair by implantation of an alloplastic prosthesis by the Stoppa-Rives technique.

Main outcome measures: Postoperative deep prosthetic infection and associated factors.

Results: All 121 patients had the mesh implanted in the subfascial plane, 77 had a polypropylene mesh (Prolene) (64%), 7 had a polyester mesh (Mersilene) (6%), and 37 patients had a expanded polytetrafluoroethylene patch (ePTFE, Gore-Tex) (31%). Postoperatively the mesh became infected in 8 patients (7%), a mean of 4.5 months (range 0.5-16) after hernia repair. All three infected ePTFE patches had to be removed whereas drainage was sufficient treatment for the infected polypropylene and polyester meshes.

Conclusion: Once a mesh infection is verified adequate drainage seems to be sufficient for polypropylene and polyester meshes but ePTFE patches should be removed.