Evidence map›Paper›PMID 40632316›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2025

Does prior mesh infection matter? Clinical outcomes of patients undergoing complex abdominal wall reconstruction after infected mesh explantation.

Daphne Remulla, Brianna L Slatnick, Kimberly P Woo, William C Bennett, Alvaro Carvalho, Cammy Tang, Kimberly S Miles, Li-Ching Huang, Benjamin T Miller, Lucas R Beffa and 4 more

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In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Histopathological features and tissue remodeling in chronic abdominal wall mesh infection - a clinicopathological study.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
    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

14 authors.

Daphne RemullaDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA. remulld@ccf.org.ORCID 0000-0001-6856-9146
Brianna L SlatnickDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Kimberly P WooDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
William C BennettDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Alvaro CarvalhoDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Cammy TangCleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Kimberly S MilesDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Li-Ching HuangDepartment of Biostatistics, Vanderbilt University, Nashville, TN, USA.
Benjamin T MillerDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Lucas R BeffaDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
David M KrpataDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Clayton C PetroDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Ajita S PrabhuDepartment of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Michael J RosenDepartment of Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile mesh infection after ventral hernia repair often requires explantation and subsequent repair, the association between prior mesh infection with outcomes following complex abdominal wall reconstruction remains poorly understood.

methodsA two-stage propensity score-matched analysis was performed using the Abdominal Core Health Quality Collaborative database. Patients undergoing clean, elective, open ventral hernia repair with prior mesh infections were compared with those with no prior wound morbidity and non-mesh-related surgical site infections (SSIs). All patients underwent elective open ventral hernia repair with transversus abdominis release (TAR) and retromuscular synthetic mesh placement.

resultsAfter propensity score matching, 205 patients with prior mesh infection were matched to 205 patients with prior non-mesh-related SSI and to 548 patients with no prior wound morbidity. Patients with a prior mesh infection experienced significantly higher rates of 30-day surgical site occurrences (SSO) (24.9% vs. 14.1%; p < 0.001) and surgical site occurrences requiring procedural intervention (14.1% vs. 7.7%; p = 0.007), compared with those with no prior wound morbidity. Compared with those with prior non-mesh-related SSIs, patients with a prior mesh infection also had a higher rate of SSO (25% vs. 14%; p = 0.004) and a higher proportion of deep SSIs (65% vs. 20%; p = 0.004). Despite these differences, mesh excision rates were low across all groups (0.1-0.2%). Patients with prior mesh infection reported significantly worse quality of life at baseline (median HerQLes: 22 vs. 32; p = 0.008) and worse pain scores at 30 days (median PROMIS 3 A: 52 vs. 46; p = 0.007). Reoperation and hernia recurrence rates were similar between groups throughout the five-year follow-up period.

conclusionsPrior mesh infection is associated with increased short-term wound morbidity following complex abdominal wall reconstruction, despite similar long-term hernia recurrence rates and low rates of mesh excision. While transversus abdominis release (TAR) with retromuscular mesh placement may mitigate the risk of repeated mesh infection and explantation, prior mesh infections impact patient outcomes well beyond the immediate postoperative period. These findings can help guide informed discussion and set appropriate patient expectations.

Indexed as

Abdominal WallHernia, VentralHerniorrhaphySurgical MeshSurgical Wound InfectionAgedDevice RemovalFemaleHumansMaleMiddle AgedPropensity ScoreReoperationRetrospective StudiesTreatment OutcomeMesh infectionOutcomesSurgical site infectionVentral hernia

Identifiers

PMID40632316

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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.