title: Effects of macroporous monofilament mesh on infection in a contaminated field.
abstract: BACKGROUND
  The aim of this study was to evaluate whether the type of the mesh and proper surgical technique can influence the outcome of a tension-free hernia repair in a contaminated filed.
  
  
  METHODS
  This study was based on the model of bacterial peritonitis in rats induced with a mixture composed of Escherichia coli and Bacteroides fragilis. Two animals were used as a control group without induced peritonitis and 10 animals with mesh implanted inside of the peritoneal cavity. For the 20 animals in the studied group, bacterial fluid was applied into the abdominal cavity together with the mesh implantation. In 10 cases, the mesh was fixed flatly upon the surface of the peritoneum; in the other 10, the mesh was rolled and then fixed within the peritoneal cavity. After 5 weeks, the animals were operated on again, and the meshes, the peritoneal fluid and, if present, any granulomas were taken for bacterial cultivation.
  
  
  RESULTS
  The results of the bacterial cultivation of the material from the control group (without mesh) and from the rats with flatly fixed mesh were almost completely negative (0/10 and 1/10, respectively). In 9 out of 10 rats that were exposed to the rolled mesh for 5 weeks, the colonisation of meshes with both B. fragilis and E. coli was found (p < 0.0198).
  
  
  CONCLUSIONS
  When properly fixed, flat mesh, even in a contaminated field, may allow for a proper mesh healing and does not influence the ability to cure bacterial peritonitis in an animal model. A bad surgical technique, such as inadequately positioned or rolled mesh, may cause persistent peritoneal bacteraemia.
authors.affiliation: Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland, kamilbury@me.com.
authors.forename: Kamil
authors.initials: K
authors.lastname: Bury
authors.forename: Maciej
authors.initials: M
authors.lastname: Smietański
authors.forename: Bigda
authors.initials: B
authors.lastname: Justyna
authors.forename: Piotr
authors.initials: P
authors.lastname: Gumiela
authors.forename: Anna Irmina
authors.initials: AI
authors.lastname: Smietańska
authors.forename: Radosław
authors.initials: R
authors.lastname: Owczuk
authors.forename: Lukasz
authors.initials: L
authors.lastname: Naumiuk
authors.forename: Alfred
authors.initials: A
authors.lastname: Samet
authors.forename: J
authors.initials: J
authors.lastname: Paradziej-Łukowicz
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000601:surgery*; D004867:Equipment Design; D046449:Hernia, Abdominal / Q000601:surgery*; D008297:Male; D010538:Peritonitis / Q000382:microbiology / Q000601:surgery*; D011126:Polypropylenes; D017208:Rats, Wistar; D013526:Surgical Mesh / Q000382:microbiology; D013530:Surgical Wound Infection / Q000382:microbiology
chemical_list: D011126:Polypropylenes