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

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.