Evidence map›Paper›PMID 35286510›Full record

Observational studyHernia : the journal of hernias and abdominal wall surgery2022

Are late hernia mesh complications linked to Staphylococci biofilms?

P Patiniott, A Jacombs, L Kaul, H Hu, M Warner, B Klosterhalfen, A Karatassas, G Maddern, K Richter

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Hernia : the journal of hernias and abdominal wall surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
  6. Review
  7. Biofilm · 2023
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

P PatiniottSurgery Department, The Queen Elizabeth Hospital and Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, Australia.ORCID 0000-0001-6005-6012
A JacombsMacquarie University Hospital, Macquarie University, Sydney, Australia.ORCID 0000-0002-5773-1993
L KaulSurgery Department, The Queen Elizabeth Hospital and Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, Australia.ORCID 0000-0002-8820-036X
H HuFaculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.ORCID 0000-0002-3749-4089
M WarnerMicrobiology and Infectious Diseases Directorate, SA Pathology, Adelaide, Australia.ORCID 0000-0002-4053-1610
B KlosterhalfenMVZ für Histologie, Zytologie und Molekulare Diagnostik Düren GmbH, Düren, Germany.
A KaratassasSurgery Department, The Queen Elizabeth Hospital and Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, Australia.ORCID 0000-0002-8000-5076
G MaddernSurgery Department, The Queen Elizabeth Hospital and Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, Australia.ORCID 0000-0003-2064-181X
K RichterSurgery Department, The Queen Elizabeth Hospital and Basil Hetzel Institute for Translational Health Research, The University of Adelaide, Adelaide, Australia. Katharina.Richter@adelaide.edu.au.ORCID 0000-0003-2979-8215

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to investigate the link between bacterial biofilms and negative outcomes of hernia repair surgery. As biofilms are known to play a role in mesh-related infections, we investigated the presence of biofilms on hernia meshes, which had to be explanted due to mesh failure without showing signs of bacterial infection.

methodsIn this retrospective observational study, 20 paraffin-embedded tissue sections from explanted groin hernia meshes were analysed. Meshes have been removed due to chronic pain, hernia recurrence or mesh shrinkage. The presence and bacterial composition of biofilms were determined. First, specimens were stained with fluorescence in situ hybridisation (FISH) probes, specific for Staphylococcus aureus and coagulase-negative staphylococci, and visualised by confocal laser scanning microscopy. Second, DNA was extracted from tissue and identified by S. aureus and S. epidermidis specific PCR.

resultsConfocal microscopy showed evidence of bacterial biofilms on meshes in 15/20 (75.0%) samples, of which 3 were positive for S. aureus, 3 for coagulase-negative staphylococci and 9 for both species. PCR analysis identified biofilms in 17/20 (85.0%) samples, of which 4 were positive for S. aureus, 4 for S. epidermidis and 9 for both species. Combined results from FISH/microscopy and PCR identified staphylococci biofilms in 19/20 (95.0%) mesh samples. Only 1 (5.0%) mesh sample was negative for bacterial biofilm by both techniques.

conclusionResults suggest that staphylococci biofilms may be associated with hernia repair failure. A silent, undetected biofilm infection could contribute to mesh complications, chronic pain and exacerbation of disease.

Indexed as

Chronic PainStaphylococcal InfectionsBiofilmsCoagulaseHerniaHerniorrhaphyHumansStaphylococcusStaphylococcus aureusStaphylococcus epidermidisSurgical MeshCoagulaseBiofilmsChronic painHerniaImplant infectionMesh complicationMesh failureStaphylococcus aureus

Identifiers

PMID35286510
PMCPMC9525333

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.