Can the wounds after infected meshes removal be sutured primarily: a retrospective study

Abstract

Objective To explore the efficacy of debridement and primary suture for mesh-related infections after tension-free inguinal hernia repair. Methods From January 2007 to December 2013, 208 cases with mesh infections following inguinal hernia repairs were treated with debridement in Department of Hernia and Abdominal Wall Surgery of Beijing Chaoyang Hospital, 147 cases were treated with primary suture (suture group) and 61 cases were treated with dressing change (open group). Results The mean time of mesh infection was (8.37±6.89) months. The results of bacterial culture in the two groups were similar. First grade healing rate of suture group was 80.95% (119/147), compared to zero percent in open group. Length of stay [(20.86±7.90)d vs. (31.82±11.50)d, t=3.47, P=0.034] and hospital cost [(3 200±5 800) yuan vs. (26 500±6 600) yuan, t=4.51, P=0.02] in suture group were less than in open group. No patients developed recurrent hernia in suture group compared with one recurrence in open group. Conclusions Debridement and primary suture for mesh-related infections after tension-free inguinal hernia repair could increase the rate of first grade healing, shorten average length of hospital stay and reduce total costs. Key words: Hernia, inguinal; Herniorrhaphy; Mesh infection; Debridement; Primary suture