title: [Prosthetic infection after hernioplasty. Five years experience].
abstract: 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.
authors.affiliation: Unidad de Cirugía General y Urgencias, Sección de Pared abdominal, Hospital Universitario La Fe, Valencia, Spain. buenolledo@hotmail.com
authors.forename: Jose
authors.initials: J
authors.lastname: Bueno Lledó
authors.forename: Yurena
authors.initials: Y
authors.lastname: Sosa Quesada
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Gomez I Gavara
authors.forename: Javier
authors.initials: J
authors.lastname: Vaqué Urbaneja
authors.forename: Fernando
authors.initials: F
authors.lastname: Carbonell Tatay
authors.forename: Santiago
authors.initials: S
authors.lastname: Bonafé Diana
authors.forename: Providencia
authors.initials: P
authors.lastname: García Pastor
authors.forename: Ricardo
authors.initials: R
authors.lastname: Baquero Valdelomar
authors.forename: José
authors.initials: J
authors.lastname: Mir Pallardó
mesh_terms: 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