The Clinical Characteristics and Treatment of Mesh Infection After Laparoscopic Inguinal Hernia Repair

Abstract

Background: Mesh infection after inguinal hernia repair (MILIHR) is one of the rare and most serious complications. The aim of our study was to analyze the clinical characteristics and treatment methods of MILIHR.Methods: Two MILIHR cases admitted to Beibei Traditional Chinese Medical Hospital were reported, and 32 MILIHR cases reported in Chinese and English literatures were retrieved. The clinical features and treatment of MILIHR in 34 cases were analyzed.Results: In case 1, medical glue was found in in the infected area, and in case 2, the infection focal point was the residual hernia sac covering the pus. Risk factors of other cases included obesity, smoking, malignant tumor, diabetes, postoperative hematoma, postoperative aspiration of seroma, steroid or immunosuppressive drugs use, etc. The results of pathogen culture showed that there were 14 cases of Staphylococcus, 5 cases of Escherichia coli, 5 cases of Pseudomonas, 1 case of Hemolytic streptococcus, 2 cases of fungi, 2 cases of pseudoinfection (rejection). 33 cases were cured after the mesh was removed, and 1 case was cured after conservative treatment. The mesh was removed by laparoscopic surgery in 22 cases and by open surgery in 11 cases.Conclusions: The risk factors of MILIHR are multifactorial，and the using of medical glue and residual hernia sac may be the risk factors of mesh infection. The main pathogens of MILIHR were Staphylococcus, Escherichia coli and Pseudomonas. The most reliable way to treat MILIHR is to remove the mesh completely. The removal of the infected mesh by laparoscopic surgery can clearly identify the important anatomical structures and avoid anterior approach abdominal wall damage during re-hernia repair.