title: Partial versus complete removal of the infected mesh after abdominal wall hernia repair.
abstract: BACKGROUND
  To compare the results with complete mesh removal (CMR) versus partial mesh removal (PMR) in the treatment of mesh infection after abdominal wall hernia repair (AWHR).
  
  
  METHODS
  Retrospective review of all patients who underwent surgery for mesh infection between January 2004 and May 2014 at a tertiary center.
  
  
  RESULTS
  Of 3470 cases of AWHR, we reported 66 cases (1.9%) of mesh infection, and 48 repairs (72.7%) required mesh explantation. CMR was achieved on 38 occasions, while PMR was undertaken ten times. We observed more postoperative complications in CMR than PMR group (p = 0.04). Three patients with intestinal fistula were reoperated in postoperative period after a difficult mesh removal; one of them died due to multiple organ failure. The overall recurrence rate after explantation was 47.9%: recurrence was more frequent in CMR group (p = 0.001), although persistent or new mesh infection was observed more frequently with PMR (p = 0.001).
  
  
  CONCLUSIONS
  Although PMR has less postoperative morbidity, shorter duration of hospitalization and lower rate of recurrence than CMR, prosthetic infection persists in up to 50% of cases.
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, "La Fe" Universitary Hospital, University of Valencia, Valencia, 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, "La Fe" Universitary Hospital, University of Valencia, Valencia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Torregrosa-Gallud
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, "La Fe" Universitary Hospital, University of Valencia, Valencia, Spain.
authors.forename: Omar
authors.initials: O
authors.lastname: Carreño-Saénz
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, "La Fe" Universitary Hospital, University of Valencia, Valencia, Spain.
authors.forename: Providencia
authors.initials: P
authors.lastname: García-Pastor
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, "La Fe" Universitary Hospital, University of Valencia, Valencia, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Carbonell-Tatay
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, "La Fe" Universitary Hospital, University of Valencia, Valencia, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Bonafé-Diana
authors.affiliation: Surgical Unit of Abdominal Wall, Department of Digestive Surgery, "La Fe" Universitary Hospital, University of Valencia, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Iserte-Hernández
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D000328:Adult; D000368:Aged; D020878:Device Removal; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*
keywords: Abdominal wall hernia; Hernia repair; Mesh explantation; Mesh infection