Factors related to successful mesh salvage with negative pressure wound therapy: a retrospective cohort study.

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  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: France NLM ID: 9715168 Publication Model: Electronic Cited Medium: Internet ISSN: 1248-9204 (Electronic) Linking ISSN: 12489204 NLM ISO Abbreviation: Hernia Subsets: MEDLINE
    • Publication Information:
      Original Publication: Paris, France : Springer, c1997-
    • Subject Terms:
      Negative-Pressure Wound Therapy* ; Surgical Mesh*/adverse effects ; Herniorrhaphy*/adverse effects ; Salvage Therapy* ; Surgical Wound Infection*/therapy ; Surgical Wound Infection*/etiology; Humans ; Male ; Retrospective Studies ; Female ; Middle Aged ; Aged ; Risk Factors ; Adult ; Smoking/adverse effects
    • Abstract:
      Background: Mesh salvage using negative pressure wound therapy (NPWT) in cases of mesh infection following hernia repair has emerged as an alternative to early mesh removal. However, the factors related to the success or failure of mesh salvage with NPWT remain unclear.
      Methods: This retrospective cohort study included 61 patients with mesh infections after hernia repair treated with NPWT between 2018 and 2024. We analyzed demographic, clinical, and surgical variables, as well as the bacterial spectrum and antimicrobial susceptibility. A binary logistic regression model was used to identify factors associated with NPWT failure, defined as the need for mesh removal.
      Results: Mesh salvage was successful in 80.3% of cases. Active smoking was significantly associated with NPWT failure (OR = 7.82, CI 95% 1.05-64.8; p = 0.044). Other factors, such as age, body mass index, Charlson comorbidity index, mesh type, and mesh position, were not significantly related to failure. Most infections were caused by Staphylococcus aureus (24.6%) and Escherichia coli (22.9%).
      Conclusions: NPWT is an effective method for salvaging infected meshes, with a high success rate. Active smoking was identified as a risk factor for NPWT failure, highlighting the need for early identification of patients who may benefit from alternative approaches. Further studies are required to develop predictive models for NPWT success in mesh salvage.
      Competing Interests: Declarations. Conflict of interest: All authors declare no conflicts of interest. Ethical standards: Ethical compliance with the Helsinki Declaration, current legislation on research Res. 008430–1993 and Res. 2378–2008 (Colombia) and the International Committee of Medical Journal Editors (ICMJE) were ensured under our Ethics and Research Institutional Committee (IRB) approval. Human and animal rights: All procedures involving human participants were in accordance with ethical standards of the institution. Data were processed according to law on the protection of personal data. Informed consent: Informed consent was filled out as required for the execution of this study.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Hernia; Mesh infection; Mesh salvage; NPWT; Negative pressure wound therapy; Wound infection
    • Publication Date:
      Date Created: 20241205 Date Completed: 20241205 Latest Revision: 20241207
    • Publication Date:
      20241209
    • Accession Number:
      PMC11618176
    • Accession Number:
      10.1007/s10029-024-03233-3
    • Accession Number:
      39633022