3rd Department of Surgery of 1st Faculty of Medicine at Charles University, Motol University Hospital, Prague, Czech Republic.
Department of Surgical Science, Emergency Surgery Unit, University of Cagliari, Cagliari, Italy.
Hernia. 2023 Dec;27(6):1387-1395. doi: 10.1007/s10029-023-02795-y. Epub 2023 May 19.
There is a reasonable body of evidence around oral/dental health and implant infection in orthopaedic and cardiovascular surgery. Another large area of surgical practice associated with a permanent implant is mesh hernia repair. This study aimed to review the evidence around oral/dental health and mesh infection.
The research protocol was registered in PROSPERO (CRD42022334530). A systematic review of the literature was undertaken according to the PRISMA 2020 statement. The initial search identified 582 publications. A further four papers were identified from references. After a review by title and abstract, 40 papers were read in full text. Fourteen publications were included in the final review, and a total of 47,486 patients were included.
There is no published evidence investigating the state of oral hygiene/health and the risk of mesh infection or other infections in hernia surgery. Improvement in oral hygiene/health can reduce surgical site infection and implant infection in colorectal, gastric, liver, orthopaedic and cardiovascular surgery. Poor oral hygiene/health is associated with a large increase in oral bacteria and bacteraemia in everyday activities such as when chewing or brushing teeth. Antibiotic prophylaxis does not appear to be necessary before invasive dental care in patients with an implant.
Good oral hygiene and oral health is a strong public health message. The effect of poor oral hygiene on mesh infection and other complications of mesh hernia repair is unknown. While research is clearly needed in this area, extrapolating from evidence in other areas of surgery where implants are used, good oral hygiene/health should be encouraged amongst hernia patients both prior to and after their surgery.
口腔/牙齿健康与骨科和心血管手术中的植入物感染相关，这方面已经有大量证据。另一个与植入物永久使用相关的重要手术领域是网片疝修补术。本研究旨在综述口腔/牙齿健康与网片感染的相关证据。
本研究按照 PRISMA 2020 声明进行了文献系统性回顾，研究方案已在 PROSPERO 上注册（CRD42022334530）。最初检索到 582 篇文献，进一步从参考文献中确定了 4 篇文献。经过标题和摘要筛选后，阅读了 40 篇全文。最终有 14 篇文献被纳入综述，共计纳入 47486 例患者。
目前尚无研究调查疝修补术中口腔卫生/健康状况与网片感染或其他感染的风险。改善口腔卫生/健康状况可以降低结直肠、胃、肝、骨科和心血管手术中的手术部位感染和植入物感染风险。日常活动（如咀嚼或刷牙）中口腔卫生差会导致口腔细菌和菌血症大量增加。对于有植入物的患者，在进行有创性牙科护理之前，似乎不需要进行抗生素预防。
良好的口腔卫生和口腔健康是一个强有力的公共卫生信息。口腔卫生差对网片感染和网片疝修补术其他并发症的影响尚不清楚。虽然该领域显然需要开展研究，但可以从植入物用于其他手术领域的证据推断，在手术前和手术后，都应鼓励疝患者保持良好的口腔卫生/健康。
