Late Polypropylene Mesh Susceptibility to Infection during Intra-Abdominal Sepsis

ABSTRACT

Purpose: To evaluate the susceptibility of high-density polypropylene mesh to contamination, 1 year after experimental hernia repair. Methods: Wistar rats were randomized into two groups: one experimental group (n = 20) and another control group (n = 10). Mesh hernia repair was performed with intra-abdominal (group I, n = 10) or subcutaneous (group II, n = 10) implantation of grafts. The three groups were exposed to an intra-abdominal E. coli administration after 1 year of operation. After 24 hr, the meshes and peritoneum were sampled from the experimental and control groups, respectively, in order to assess bacterial inoculation. Immunoreaction to E. coli inoculation was also evaluated after 24 hr by measuring serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels. Results: Bacteriological analysis revealed increased contamination in groups I and II when compared with the control group (p = .001 and .007, respectively). IL-6 levels were increased in both groups I and II compared with the control group, 24 hr after E. coli injection (p = .034 and .022, respectively), while there was no statistically significant difference between groups concerning the concentration of CRP. Conclusions: Polypropylene mesh is vulnerable to bacterial inoculation during intra-abdominal sepsis 1 year after mesh placement.

Keywords: :

• hernia repair
• mesh
• delayed infection
• intra-abdominal sepsis