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Does Presoaking Synthetic Mesh in Antibiotic Solution Reduce Mesh Infections? An Experimental Study

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Prosthetic mesh infection is one of the most challenging complications after hernia repair. We evaluate the efficacy of soaking mesh in antibiotics to prevent prosthetic infection in an animal model of clean–contaminated ventral hernia repair (VHR).

Material and Methods

Rats underwent an acute VHR with one of four synthetic meshes (composite multifilament polyester (Parietex PCO), multifilament polyester (Parietex TET), composite monofilament polypropylene (Ventralight), or monofilament polypropylene (SoftMesh)). Prior to implantation, mesh was soaked in saline or 10 mg/ml of vancomycin for 15 min. Following implantation, meshes were contaminated with 104 CFU of methicillin-resistant Staphylococcus aureus (MRSA) bacteria. Thirty days after implantation, mesh samples were cultured and evaluated under scanning electron microscope for biofilm formation.

Results

Presoaking meshes significantly improves bacterial clearance in composite meshes and multifilament polyester mesh. MRSA clearance was as follows for all meshes (saline-soaked vs. vanco-soaked): Parietex PCO (0 vs. 56 %, p = 0.006), Parietex TET (0 vs. 50 %, p = 0.01), Ventralight (20 vs. 78 %, p = 0.012), and SoftMesh (70 vs. 80 %, p = 0.6). MRSA biofilm formation was consistent with bacterial growth.

Conclusion

Presoaking multifilament and composite mesh in vancomycin solution reduces MRSA bacterial growth. Its implementation may reduce the risk of mesh infection in clean–contaminated cases, although further investigation with human trials should be performed.

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Acknowledgments

This work was funded through an internal department of surgery grant at Case Western Reserve University.

Disclosures

Michael Rosen and Yuri Novitsky are speakers for Davol Inc. and Lifecell.

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Authors and Affiliations

  1. Case Comprehensive Hernia Center, Department of Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106-5047, USA

    Emmanuel E. Sadava, David M. Krpata, Yue Gao, Yuri W. Novitsky & Michael J. Rosen

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  1. Emmanuel E. Sadava
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  2. David M. Krpata
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  3. Yue Gao
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  4. Yuri W. Novitsky
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  5. Michael J. Rosen
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Correspondence to Michael J. Rosen.

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Sadava, E.E., Krpata, D.M., Gao, Y. et al. Does Presoaking Synthetic Mesh in Antibiotic Solution Reduce Mesh Infections? An Experimental Study. J Gastrointest Surg 17, 562–568 (2013). https://doi.org/10.1007/s11605-012-2099-8

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  • DOI: https://doi.org/10.1007/s11605-012-2099-8

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