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Outcomes of Immediate Multistaged Abdominal Wall Reconstruction of Infected Mesh: Predictors of Surgical Site Complications and Hernia Recurrence.

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Citation: Annals of Plastic Surgery. 91(4):473-478, 2023 10 01.PMID: 37713152Institution: MedStar Washington Hospital CenterDepartment: Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Abdominal Wall | Abdominal Wall/su [Surgery] | Hernia | Herniorrhaphy/ae [Adverse Effects] | Humans | Prostheses and Implants | Surgical Mesh | Surgical Wound Infection/ep [Epidemiology] | Surgical Wound Infection/et [Etiology] | Surgical Wound Infection/su [Surgery] | Year: 2023 ISSN:

0148-7043

Name of journal: Annals of plastic surgeryAbstract: BACKGROUND: Mesh infection is one of the most devastating complications after ventral hernia repair. To date, no clear consensus exists on the optimal timing of definitive abdominal wall reconstruction (AWR) after excision of infected mesh. We evaluated outcomes of immediate multistaged AWR in patients with mesh infection.CONCLUSION: Immediate multistaged AWR is an effective surgical approach in patients with infected mesh. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.METHODS: We performed a retrospective review of patients with mesh infection who underwent immediate, multistaged AWR, which consisted of exploratory laparotomy with debridement and mesh explantation, followed by definitive AWR during the same admission. Primary outcomes included hernia recurrence and surgical site occurrences, defined as wound dehiscence, surgical site infection, hematoma, and seroma.RESULTS: Forty-seven patients with infected mesh were identified. At mean follow-up of 9.5 months, 5 patients (10.6%) experienced hernia recurrence. Higher body mass index (P = 0.006), bridge repair (P = 0.035), and postoperative surgical site infection (P = 0.005) were associated with hernia recurrence.All authors: Alimi Y, Deldar R, Sosin M, Lofthus A, Nijhar K, Bartholomew AJ, Fan KL, Bhanot PFiscal year: FY2024 Digital Object Identifier:

https://dx.doi.org/10.1097/SAP.0000000000003641

Date added to catalog: 2023-11-22

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Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	37713152	Available		37713152

BACKGROUND: Mesh infection is one of the most devastating complications after ventral hernia repair. To date, no clear consensus exists on the optimal timing of definitive abdominal wall reconstruction (AWR) after excision of infected mesh. We evaluated outcomes of immediate multistaged AWR in patients with mesh infection.

METHODS: We performed a retrospective review of patients with mesh infection who underwent immediate, multistaged AWR, which consisted of exploratory laparotomy with debridement and mesh explantation, followed by definitive AWR during the same admission. Primary outcomes included hernia recurrence and surgical site occurrences, defined as wound dehiscence, surgical site infection, hematoma, and seroma.

RESULTS: Forty-seven patients with infected mesh were identified. At mean follow-up of 9.5 months, 5 patients (10.6%) experienced hernia recurrence. Higher body mass index (P = 0.006), bridge repair (P = 0.035), and postoperative surgical site infection (P = 0.005) were associated with hernia recurrence.

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