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Peer-reviewed veterinary case report

Mesh removal and repair with absorbable mesh after infection

By Joliat GR et al.·2025·Department of Visceral Surgery·View original on Europe PMC

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Original publication title: Mesh removal and ventral hernia repair with long-term absorbable mesh in case of mesh infection.

Plain-English summary

This study looked at how well a treatment worked for patients who had infections after surgery to repair a ventral hernia, which is a bulge in the abdominal wall. The researchers focused on patients who had the infected mesh removed and replaced with a special type of mesh that can dissolve over time. They found that out of 29 patients, some had complications after surgery, but overall, the long-term results were promising, with low rates of hernia returning. Specifically, 21% of patients with acute infections had their hernia come back, while none of those with chronic infections did. In summary, while there were some immediate challenges, the long-term outcomes were good, suggesting that this treatment approach can be effective.

Abstract

<h4>Purpose</h4>Mesh infection after ventral hernia repair remains rare, but often necessitates mesh removal. This study evaluated the short- and long-term outcomes of a strategy involving explantation of the infected mesh and insertion of a long-term absorbable mesh in acute (AMI) and chronic mesh infections (CMI).<h4>Methods</h4>A retrospective study was performed in two tertiary centers (01.01.2017-31.12.2024). All consecutive patients with ventral mesh infection who underwent mesh explantation followed by placement of a long-term absorbable poly-4-hydroxybutyrate mesh were included. Primary endpoint was hernia recurrence rate. AMI was defined as mesh infection within 90 postoperative days.<h4>Results</h4>Twenty-nine patients were included: 14 AMI/15 CMI. Meshes were intraperitoneal in 9/14 (64%) AMI and in 13/15 (87%) CMI patients. Twelve (86%) and 13 patients (87%) had a new mesh implanted in the retromuscular space in the AMI and CMI groups, respectively. Four (28%) and 3 patients (21%) needed posterior component separations in the AMI and CMI groups. Median hospital stays were 10 (5-15) and 7 days (5-13) in both groups. Nine patients in each group (64%/60%) developed postoperative complications. Hernia recurrence rates were 3/14 (21%) and 0 in the AMI and CMI groups (mean follow-up 17 months). One mesh had to be explanted in the AMI group (0 in the CMI group).<h4>Conclusions</h4>The presented strategy was associated with high short-term morbidity, but good long-term results, with low mesh explantation and hernia recurrence rates. A longer follow-up and inclusion of more patients is required to assess the risk of hernia recurrence and reinfection with greater hindsight.

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Original publication on Europe PMC: https://europepmc.org/article/MED/41085812