Olona Casas Carles, Caro-Tarrago Aleidis, Casanova Raquel, Vallve-Bernal Marc, Farres Cristina, Ferreres Joan, Jorba Rosa
Department of General and Digestive Surgery, Joan XXIII University Hospital of Tarragona, Research Group in General and Digestive Surgery (RECERGAD), Tarragona, Spain.
J Abdom Wall Surg. 2025 Jul 29;4:14786. doi: 10.3389/jaws.2025.14786. eCollection 2025.
The incidence of surgical site infection (SSI) in incisional hernia surgery may vary from 10% to 33% in clean-contaminated fields. Although wide-pore polypropylene prostheses are described as being able to resist infection, they are not exempt from morbidity that can lead to a catastrophic scenario associated with high recurrence. To avoid these complications, there are new polypropylene prostheses embedded with silver ions with bactericidal effects. We present the first experience described with the use of this type of prosthesis in a case series of incisional hernia surgery in clean-contaminated fields.
Single-center, retrospective, observational study on a prospectively collected sample of patients undergoing incisional hernia surgery in clean-contaminated fields. All patients who required ostomy reconstruction or bowel resection and had incisional hernia treated with silver-impregnated prostheses were included. Both procedures were performed in a single procedure using a silver ion-impregnated polypropylene mesh for wall surgery. Demographic data, hernia characteristics, surgical technique and follow-up data are collected. The results obtained in our series are described and compared with a similar previous series of our team using conventional polypropylene prostheses.
From July 2022 to December 2024, 12 patients underwent surgery with clean-contaminated wounds subjected to midline incisional hernia surgery with Optilene Silver Mesh Elastic. Ten retromuscular repairs, one anterior component separation and one onlay repair were performed. The mean follow-up was 12 months, with no SSI or prosthesis explants. At follow-up, the control group presented SSI in 3 (27.3%) cases, compared to 0 cases in the silver mesh group, with differences close to statistical significance (p = 0.052). The rest of the follow-up variables did not show statistically significant differences.
The use of silver-impregnated polypropylene prostheses can be a safe alternative for use in clean-contaminated fields, with no SSI in our series.
在清洁-污染手术区域，切口疝手术的手术部位感染（SSI）发生率可能在10%至33%之间。尽管大孔径聚丙烯假体被描述为能够抵抗感染，但它们仍无法避免可能导致与高复发率相关的灾难性后果的发病情况。为避免这些并发症，出现了嵌入具有杀菌作用的银离子的新型聚丙烯假体。我们展示了在清洁-污染手术区域的切口疝手术病例系列中使用此类假体的首次经验描述。
对在清洁-污染手术区域接受切口疝手术的患者的前瞻性收集样本进行单中心、回顾性观察研究。纳入所有需要造口重建或肠切除且使用含银假体治疗切口疝的患者。两种手术均在单一手术中进行，使用含银离子的聚丙烯网片进行腹壁手术。收集人口统计学数据、疝的特征、手术技术和随访数据。描述我们系列中获得的结果，并与我们团队之前使用传统聚丙烯假体的类似系列进行比较。
2022年7月至2024年12月，12例患者接受了使用Optilene Silver Mesh Elastic进行中线切口疝手术的清洁-污染伤口手术。进行了10例肌后修补、1例前入路成分离断术和1例覆盖修补术。平均随访12个月，无手术部位感染或假体取出情况。随访时，对照组有3例（27.3%）发生手术部位感染，而银网组为0例，差异接近统计学意义（p = 0.052）。其余随访变量未显示统计学显著差异。
使用含银聚丙烯假体在清洁-污染手术区域可能是一种安全的选择，在我们的系列中无手术部位感染发生。
