Surgical site infection after ventral hernia repair with synthetic mesh

Surgical site infections (SSIs) are common after complex ventral hernia repairs and result in prolonged hospital stays and additional morbidity. There are many modifiable risk factors that might lower the risk of infection, ranging from patient preparation to surgical technique. When infection occurs, treatment varies from local therapy to radical resection and reconstruction. Superficial SSI without mesh involvement can be treated with drainage and antibiotics, but when deep infections occur in the setting of synthetic mesh, the infected mesh is usually removed. Mesh may be salvageable when the infection is localized, but many mesh infections require complete removal and abdominal wall reconstruction. These complicated operations carry a high risk of subsequent surgical site occurrences and a substantial incidence of recurrent hernia. As techniques evolve, the goal in infected mesh cases is to clear the septic source and provide a durable abdominal wall reconstruction.