Management of Infections of Polytetrafluoroethylene-Based Mesh

Background: Mandatory removal of infected expanded polytetrafluoroethylene (ePTFE) mesh has been advocated, leading to a high rate of hernia recurrence. Although salvage of infected mesh has been reported, the feasibility, efficacy, and long-term outcomes of this practice remain unclear. The purpose of this study was to delineate a protocol for salvaging infected ePTFE mesh. Methods: We reviewed retrospectively the records of patients with infections of ePTFE-based mesh placed for complex abdominal hernias at a tertiary referral center from October 1997 to September 2005. Results: Twenty-two patients were treated for ePTFE-based mesh infections. Fifteen patients had undergone laparoscopic repair, and seven patients had undergone open repair. The median time of presentation after repair was 70 days (range 10–480 days). Fourteen patients had an extensive mesh infection and underwent mesh excision, with twelve patients having attempted fascial closure; hernias recurred in all twelve patients. Two patients un...