[Prosthetic infection after hernioplasty. Five years experience].
BACKGROUND
Prosthesis infection is an infrequent but important complication in abdominal wall surgery. The aim of this study is to evaluate the incidence and risk factors for the infection of the prosthesis after hernia repair, as well as the treatment to apply.


METHODS
Between January 2002 and December 2006, we performed 1055 prosthetic hernia repairs: 761 inguinal hernias (72.1%), 74 umbilical hernias (7%) and 220 ventral hernias (20.9%). We prospectively analysed preoperative, intraoperative and postoperative variables, as well as the incidence of infection of surgical wound and of prosthesis. We used ASA classification for preoperative anaesthetic evaluation.


RESULTS
The overall percentage of infection of the prosthesis was 1.3%. Infection was observed in 11 repairs with polypropylene mesh (PPL), in 4 with PTFE mesh, and one case in combined mesh. Risk factors of mesh infection were: obesity (p=0.002), diabetes (p=0.020), the type of repair (p=0.047), emergency surgery (p=0.001), the type and size of mesh (p=0.003; p=0.007) and time of surgery >180 min (p<0.001). Seven of the 11 patients with infection of PPL prosthesis were resolved with conservative treatment, whereas all the cases with PTFE infection or mixed mesh needed removal to solve the problem.


CONCLUSIONS
Several factors are involved in producing a prosthesis infection. Whereas antibiotic treatment and surgical drainage of the infection can be sufficient in most PPL mesh infection, PTFE prostheses need to be removed prematurely in order to halt the infection process.
Bueno Lledó
Jose
J
Unidad de Cirugía General y Urgencias, Sección de Pared abdominal, Hospital Universitario La Fe, Valencia, Spain. buenolledo@hotmail.com
Sosa Quesada
Yurena
Y
Gomez I Gavara
Inmaculada
I
Vaqué Urbaneja
Javier
J
Carbonell Tatay
Fernando
F
Bonafé Diana
Santiago
S
García Pastor
Providencia
P
Baquero Valdelomar
Ricardo
R
Mir Pallardó
José
J
D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000601:surgery*; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects*; D013997:Time Factors