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Multicenter Study
. 2021 Dec;25(6):1529-1535.
doi: 10.1007/s10029-020-02355-8. Epub 2021 Jan 5.

Surgical management of infected abdominal wall mesh: an analysis using the American Hernia Society Quality Collaborative

C L Devin  1 , M A Olson  2 , L Tastaldi  3 , R Zheng  1 , A C Berger  4 , F Palazzo  5
Affiliations
Multicenter Study

Surgical management of infected abdominal wall mesh: an analysis using the American Hernia Society Quality Collaborative

C L Devin et al. Hernia. 2021 Dec.

Abstract

Introduction: Several management strategies exist for the treatment of infected abdominal mesh. Using the American Hernia Society Quality Collaborative, we examined management patterns and 30-day outcomes of infected mesh removal with concomitant incisional hernia repair.

Methods: All patients undergoing incisional hernia repair with removal of infected mesh were identified. A complete repair (CR) was defined as fascial closure with mesh; a partial repair (PR) was defined as fascial closure without mesh or no fascial closure with mesh. A two-tailed p value less than or equal to 0.05 was considered statistically significant.

Results: A total of 282 patients were identified: 136 patients in CR group and 146 patients in PR group. Patients had similar comorbidities but differed in wound class (class IV: 55% CR vs 83% SR, p < 0.001) and incidence of associated concomitant colorectal procedures (5% CR vs 18% SR, p = 0.015). Sublay placement was used primarily in CR (94%) compared to PR (52% inlay, 48% sublay). When comparing CR to PR, length of stay (median 6, p = 0.69), complications (40% vs 44%, p = 0.44), surgical site infections (16% vs 21%, p = 0.27), surgical site occurrence (30% vs 35%, p = 0.45), and readmission within 30 days (9% vs. 13%) were not statistically different.

Conclusions: Analysis of data from a multicenter hernia registry comparing CR and PR during infected mesh removal and concurrent incisional hernia repair has not identified higher rates of short-term complications between groups in the presence of infection.

Keywords: Chronic infection; Hernia repair; Incisional hernia; Mesh infection.

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