title: Infected large pore meshes may be salvaged by topical negative pressure therapy.
abstract: OBJECTIVE
  To evaluate the efficacy of negative pressure therapy for superficial and deep mesh infections after ventral and incisional hernia repair by a prospective monocentric observational study.
  
  
  METHODS
  During a 6-year period, 724 consecutive open ventral and incisional hernia repairs were performed. Pre- and intraoperative data as well as postoperative complications were prospectively recorded. In case of wound infection, negative pressure therapy (NPT) was our primary treatment.
  
  
  RESULTS
  Sixty-three patients (8.7 %) were treated using negative pressure therapy after primary ventral and incisional hernia repair. Infectious complications needing NPT occurred in 54 patients in the retromuscular group (54/523; 10.3 %), none when laparoscopically treated and in 9 patients (9/143; 6.3 %) treated by an open intraperitoneal mesh technique. Considering outcome, all meshes were completely salvaged in the retromuscular mesh group after a median of 5 dressing changes (range, 2-9), while in the intraperitoneal mesh, group 3 meshes needed complete (n = 2) or partial (n = 1) excision. Mean duration to complete wound closure was 44 days (range, 26-63 days).
  
  
  CONCLUSIONS
  NPT is a useful adjunct for salvage of deep infected meshes, particularly when large pore monofilament mesh is used.
authors: Department of General and Hepatobiliary Surgery and Liver Transplantation Service, Ghent University Hospital and Medical School, De Pintelaan 185 2K12 IC, 9000, Ghent, Belgium. Frederik.Berrevoet@ugent.be
authors: F
authors: F
authors: Berrevoet
authors: A
authors: A
authors: Vanlander
authors: M
authors: M
authors: Sainz-Barriga
authors: X
authors: X
authors: Rogiers
authors: R
authors: R
authors: Troisi
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D011446:Prospective Studies; D012008:Recurrence; D049291:Seroma / Q000209:etiology; D013526:Surgical Mesh / Q000009:adverse effects* / Q000382:microbiology; D013530:Surgical Wound Infection / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D055815:Young Adult