Open Inguinal Hernia Repair: Incidence of Mesh Infection

Abstract

Introduction: Wound and mesh infections after inguinal hernia repair are very severe complications. Today it is an established fact to repair hernias with meshes in various ways to prevent or delay the recurrence of hernia, but knowledge regarding the incidence of mesh infection is rare. The aim of the study was to assess the incidence of mesh infection in Open Inguinal Hernia Repair. Methods: This retrospective study was conducted at the Department of Surgery, Sylhet M.A.G Osmani Medical College, Sylhet, Bangladesh during the period from January 2020 to December 2021. The study included 400 patients who underwent mesh repair for inguinal hernia repair during the 2 years period. Among the total 400 patients, 24 were diagnosed with mesh related infections. Mesh related infections influenced by type of mesh use; surgical techniques and underlying comorbidity were all recorded. Both medical and surgical management required for mesh infection were also recorded. Use of antimicrobial included coverage of staphylococcus. Laparoscopic hernia repair cases were excluded from the study. Result: The study found 24 mesh related infection in a total of 400 patients who underwent open inguinal hernia repair. The overall mesh related infection rate was 3%. The infection was established at a variable delay after mesh insertion, with 40% delayed onset after procedure and 60% diagnosed during the first post-operative month. Infection was cured in 6 patients after mesh removal. Conclusion: Mesh removal appears to be one of the appropriate treatments for this rare and serious complication. The most common pathogen was Staphylococcus aureus and E. Coli. The possibility of a mesh related infection remains active weeks or even years after initial hernia repair. If mesh infection develops it should be treated vigorously and mesh should be excised early if necessary.