C-reactive protein is a predictive factor for complications after incisional hernia repair using a biological mesh

Abstract

The introduction of biological or absorbable synthetic meshes has provided an alternative to conventional repair for incisional hernia. The ability to predict the development of complications after hernia surgery is important, as it guides surgical planning and patient management. This retrospective study assessed whether the postoperative C-reactive protein (CRP) level can predict complications after incisional hernia repair using biological mesh reinforcement. Patients who underwent incisional hernia repair surgery using biological meshes between February 2009 and February 2015 were screened for study inclusion. Patients included in the study were divided into two groups: those with and without postoperative complications. The two groups were analysed based on sex, surgical operation, length of intensive care unit stay (ICU), complications and mortality. Laboratory values, including white blood cell (WBC) count and CRP levels, were determined preoperatively and up to postoperative day (POD) 10. Postoperative complications requiring further management occurred in 32 of the 60 patients (53.3%). Among 47 patients, the mean CRP and WBC levels were 6.6 mg/L and 9.073 G/L in the group without complications vs. 141.0 mg/L, 16.704 G/L in the group with complications (p < 0.001). Patients with complications also had a longer ICU stay (10.1 vs. 0.6 days, p < 0.0001). A cut-off was 101 mg/L and offered 80.00% sensitivity (IC 61.43% to 92.29) and 95.24% specificity (76.18% to 99.88%) for postoperative complication. The rate of postoperative complications before POD10 was 95% in the group with CRP > 100 mg/L vs. 46% in the group with CRP < 100 mg/L (p = 0.000372). A high postoperative CRP level (> 100 mg/L) up to POD10 may serve as a predictor of postoperative complications in patients undergoing incisional hernia using biological meshes.

The long‐term impact of vaginal surgical mesh devices on pain clinic and psychological service referrals, anti‐inflammatory testing and pelvic scans in UK primary care: A cohort study with the Clinical Practice Research Datalink

“…The increased testing rates for markers of immune response (CRP and ESR) in women with mesh surgery is consistent with the concerns around a host immune response to the synthetic materials found in permanent implantable medical devices 1,24,25 . CRP levels rise in response to inflammation, and this has been shown to be predictive of complications after hernia repair using biological mesh 26 . Increased demands for care over the observation period may also be related to an ageing population, although all analyses were adjusted for age.…”

“…1,24,25 CRP levels rise in response to inflammation, and this has been shown to be predictive of complications after hernia repair using biological mesh. 26 Increased demands for care over the observation period may also be related to an ageing population, although all analyses were adjusted for age.…”

Systemic immune-inflammation index within the first postoperative hour as a predictor of severe postoperative complications in upper abdominal surgery: a retrospective single-center study

“…Some perioperative inflammation markers such as high-sensitivity complement reactive protein (CRP) and procalcitonin (PCT) have been established as risk predictors to estimate the risk of SPC occurrence [ 7 , 8 ]. However, the high cost of detecting these markers and strict restrictions on the test conditions limit their wider use as clinical routine tests, especially in some developing countries.…”