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. Copyright © 2001 Taylor and Francis Ltd.