Recurrence of inguinal herniae following removal of infected prosthetic meshes: a review of the literature

Late-onset mesh infection, occurring months to years following hernia repair, is a rare complication of hernia surgery. Its management usually requires removal of the mesh. The aim of this paper was to assess the rate of recurrence of inguinal herniae following removal of the mesh for late onset deep mesh infection. We performed a literature review to assess the rate of recurrence of herniae following the removal of a delayed onset infected mesh. Relevant studies from January 1966 to June 2010 were identified from a Medline, Pub Med, Embase, Scopus and Cochrane database search. Studies that reported recurrence of the hernia following removal of delayed onset infected meshes were included. Results were tabulated and analysed to derive conclusions. Some 153 abstracts were reviewed and 12 potential studies initially identified; of these, only 7 were finally included in this review. The included studies were six case series and one case report and comprised a total of 40 patients in whom delayed-onset infected mesh was removed. The median follow-up period after the removal of the infected mesh was 26 months. Of these 40 patients, only 2 (< 5%) developed a recurrent hernia. Removal of the mesh resulted in resolution of symptoms in the majority of the patients. Based on this review, removal of a late-onset infected mesh results in resolution of symptoms in the majority of cases, whereas recurrence of hernia is not common. However, further research is required as the number of patients in our review is relatively small.