Predictors of mesh infection and explantation after abdominal wall hernia repair

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• 作者：José ; Bueno-Lledó ; Ph.D. ; ^{buenolledo@hotmail.com} ; Antonio Torregrosa-Gallud ; Ph.D. ; Angela Sala-Hernandez ; M.D. ; Fernando Carbonell-Tatay ; Ph.D. ; Providencia G. Pastor ; M.D. ; Santiago B. Diana ; M.D. ; José ; I. Herná ; ndez ; M.D.
• 关键词：Mesh infection ; Mesh explantation ; Biofilm ; Abdominal wall hernia ; Hernia repair ; Prosthesis infection
• 刊名：The American Journal of Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：213
• 期：1
• 页码：50-57
• 全文大小：190 K
• 卷排序：213

文摘

The main objective was to identify predictive factors associated with prosthesis infection and mesh explantation after abdominal wall hernia repair (AWHR).MethodsThis is a retrospective review of all patients who underwent AWHR from January 2004 to May 2014 at a tertiary center. Multivariate analysis identified predictors of mesh infection and explantation after AWHR.ResultsFrom 3,470 cases of AWHR, we reported 66 cases (1.9%) of mesh infection, and 48 repairs (72.7%) required mesh explantation. Steroid or immunosuppressive drugs use (odds ratio [OR] 2.22; confidence interval [CI] 1.16 to 3.95), urgent repair (OR 5.06; CI 2.21 to 8.60), and postoperative surgical site infection (OR 2.9; CI 1.55 to 4.10) were predictive of mesh infection. Predictors of mesh explantation were type of mesh (OR 3.13; CI 1.71 to 5.21), onlay position (OR 3.51; CI 1.23 to 6.12), and associated enterotomy in the same procedure (OR 5.17; CI 2.05 to 7.12).ConclusionsImmunosuppressive drugs use, urgent repair, and postoperative surgical site infection are predictive of mesh infection. Risk factors of prosthesis explantation are polytetrafluoroethylene mesh, onlay mesh position, and associated enterotomy in the same procedure.