Reoperations for chronic infections following prosthetic hernia repair

The growing popularity of prosthetic hernia repair has resulted in a larger number of complications such as a chronically discharging sinus; in such cases, the infected mesh may have to be removed. Five reoperations were performed in the past five years, all in male patients aged 52 to 73 years. A cylinder plug was removed in two cases, and in the other three a partial or complete removal of the mesh was required. Four of the prostheses were made of polypropylene and one of dacron. Recovery was satisfactory in all patients; infection recurred in one case six months later, and one patient developed a new hernia. Alloplasty was performed in 1,190 hernias: 16 wound infections occurred, although no meshes had to be removed due to the onset of a chronically discharging sinus. The importance of monitoring the patients' condition and offering early treatment to avoid complications is highlighted. In conclusion, inexperience in prosthetic surgery appears to be the main risk factor. Cylinder plugs are most at risk, especially the larger or tightly rolled up ones. Inguinal hernia mesh-plug repair (cone-shaped plugs) appears to be a safe and reliable operation when correctly performed and followed up.