Patients Require Long-Term Tracking for Hernia Mesh Infections

Prolene hernia mesh removed after 1.5 yr.

Mesh News Desk, February 1, 2016 ~ General Surgery News reports January 26, 2016 on a long-term study of hernia patients finds infections can take more than a year to emerge and infections are very common.

The study, conducted by the Carolinas Medical Center, in Charlotte, N.C. found anywhere from 17 percent to 66 % of patients have an infection after a ventral (midsection) hernia repair using mesh. More than 30% of those infections occurred an average of 2.2 years after the implant.

The study stresses the need for the long-term tracking of hernia patients. See General Surgery News here.

The medical center is a major referral center for hernias. One-hundred sixty-one patients were involved in this particular study which spanned over a decade.

Dr. Vedra Augenstein, Carolinas Medical Center

On average it took 2.2 years after a mesh implant before it was infected and half of the patients presented with an infection 90 days after mesh implant. Antibiotic treatment time period average 7.6 months and patients had had an average of 2.6 ventral hernia repairs.

Even though efforts were made to leave the mesh in place. Less than 10 percent of patients could leave the mesh in place, the other 90 percent had to have the mesh explanted. Of the meshes that could remain in place (salvaged) were lightweight polypropylene meshes with one third of patients able to avoid explantation. All of the patients with heavier polypropylene mesh, specifically Composix, made by C.R. Bard/Davol, had to be removed due to infection.

Mesh fistulas took an average of 2.3 years to develop with an average time of 4.3 years. Presenting the findings was lead author Vedra A. Augenstein, MD who said less than ten percent of the meshes could be salvaged.

She suggested following the Centers for Disease Control and Prevention (CDC) guidelines to follow patients for a minimum of one year after implant to rule out infection. And for an infection that may be in the works, she suggested tracking a patient’s C-reactive protein and erythrocyte sedimentation rate.

Dr. Augustin presented her findings at the 2015 Clinical Congress of the American College of Surgeons (ACS) which met in October in Chicago. See the program here.

Also presented was a discussion about the “myth” that biologic meshes cannot get infected and a concern that they too have a high recurrence rate. #