Surgical site infection in mesh repair for ventral hernia in contaminated field: A systematic review and meta-analysis

• Published in: Annals of medicine and surgery Vol. 63; p. 102173
• Main Authors: Maatouk, Mohamed, Ben Safta, Yacine, Mabrouk, Aymen, Kbir, Ghassen Hamdi, Ben Dhaou, Anis, Sami daldoul, Sayari, Sofien, Haouet, Karim, Dziri, Chadli, Ben Moussa, Mounir
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2021; Elsevier
• Subjects: Complicated hernia; Contaminated field; Surgical site infection; Systematic Review / Meta-analysis; Ventral hernia; Surgical site infection; Complicated hernia; Contaminated field; Ventral hernia
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.02.019

Given the risk of surgical site infection (SSI), the use of mesh in contaminated ventral hernia repair (VHR) is not standardized and still a clinical dilemma. This meta-analysis aimed to assess whether mesh use increased the risk of SSI in patients following VHR in contaminated field. We performed a systematic review of published literature. Studies comparing the mesh repair and anatomic repair, the use of mesh in different Center for Disease Control and Prevention (CDC) wound classes and mesh repair with synthetic mesh or other type of meshes to treat complicated and contaminated VHR were considered for analysis. The main outcome was SSI incidence. Six studies compared mesh and suture repairs. No significant difference in SSI incidence was observed between patients with complicated VHR in the mesh and suture repair groups. Five studies analyzed mesh repair in patients by field contamination level. There was no significant difference between the use of mesh in clean-contaminated, contaminated and dirty field versus clean wound class. Moreover, there was no significant difference between the use of mesh in clean-contaminated and contaminated cases. Four studies compared mesh repair technique with synthetic mesh or other type of meshes were included. The incidence of SSI was significantly lower in the synthetic mesh group. The use of mesh repair in the management of complicated VHR compared to suture repair is not associated with an increased incidence of SSI even in potentially contaminated fields. •Mesh repair in contaminated ventral hernia was associated with similar surgical site infection rate compared with anatomic repair.•The use of mesh is not associated with an increased incidence of surgical site infection even in potentially contaminated fields.•The synthetic mesh is suitable for ventral hernia repair in contaminated settings.