title: Predictors of mesh infection and explantation after abdominal wall hernia repair.
abstract: BACKGROUND
  The main objective was to identify predictive factors associated with prosthesis infection and mesh explantation after abdominal wall hernia repair (AWHR).
  
  
  METHODS
  This is a retrospective review of all patients who underwent AWHR from January 2004 to May 2014 at a tertiary center. Multivariate analysis identified predictors of mesh infection and explantation after AWHR.
  
  
  RESULTS
  From 3,470 cases of AWHR, we reported 66 cases (1.9%) of mesh infection, and 48 repairs (72.7%) required mesh explantation. Steroid or immunosuppressive drugs use (odds ratio [OR] 2.22; confidence interval [CI] 1.16 to 3.95), urgent repair (OR 5.06; CI 2.21 to 8.60), and postoperative surgical site infection (OR 2.9; CI 1.55 to 4.10) were predictive of mesh infection. Predictors of mesh explantation were type of mesh (OR 3.13; CI 1.71 to 5.21), onlay position (OR 3.51; CI 1.23 to 6.12), and associated enterotomy in the same procedure (OR 5.17; CI 2.05 to 7.12).
  
  
  CONCLUSIONS
  Immunosuppressive drugs use, urgent repair, and postoperative surgical site infection are predictive of mesh infection. Risk factors of prosthesis explantation are polytetrafluoroethylene mesh, onlay mesh position, and associated enterotomy in the same procedure.
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain. Electronic address: buenolledo@hotmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Bueno-Lledó
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Torregrosa-Gallud
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
authors.forename: Angela
authors.initials: A
authors.lastname: Sala-Hernandez
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Carbonell-Tatay
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
authors.forename: Providencia G
authors.initials: PG
authors.lastname: Pastor
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
authors.forename: Santiago B
authors.initials: SB
authors.lastname: Diana
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, Politecnic "La Fe" Hospital, University of Valencia, Valencia, 46008, Spain.
authors.forename: José I
authors.initials: JI
authors.lastname: Hernández
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D020878:Device Removal; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000453:epidemiology*
keywords: Abdominal wall hernia; Biofilm; Hernia repair; Mesh explantation; Mesh infection; Prosthesis infection