Hernia Mesh Infection

Hernia mesh infection happens when bacteria grow on mesh implants, causing symptoms such as fever, inflammation and pain. Some types of mesh may be more likely to become infected, and the risk of infection goes up in people with other health problems such as obesity or diabetes.

Last Modified: May 5, 2021
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What Is Hernia Mesh Infection?

Hernia mesh infections are deep infections that occur around the mesh implant. They are different from wound infections that occur at the surgical site.

Infections in mesh implants can occur within months or years after the initial surgery. This complication may occur because of poorly designed mesh, but it’s rarer than other more common hernia mesh surgery complications such as pain.

Researchers have reported between one and eight percent of people who had hernia repair surgery with mesh may suffer from infection.

How Do I Know if My Mesh Is Infected?

Common mesh infection symptoms range from pain to swelling. Symptoms may occur within two weeks to a few years after surgery.

“Mesh infections can manifest with chronic, persistent or recurrent symptoms and signs.”

The median time between hernia surgery for inguinal or incisional hernia repair and mesh infection was 17 months, according to a 2016 study by Dr. Tao Chen and colleagues published in Chinese Medical Journal.

Mesh infections can cause serious problems. Contact your doctor immediately if you have any signs of infection.

Signs of hernia mesh infection include:
  • Abdominal abscess (a pocket filled with pus)
  • Bone infection (rare)
  • Burning sensation
  • Chills or rigors (feeling cold while shivering and sweating)
  • Fatigue
  • Fever
  • Flu-like symptoms
  • Inflammation
  • Pain
  • Redness
  • Swollen lymph nodes
  • Tenderness
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Did your hernia mesh implant become infected after surgery?

Potential Causes of Infection

The main cause of hernia mesh infection is bacteria. The most common bacteria found in infected mesh include Staphylococcus spp. (a bacteria found in the skin) and Enterobacteriaceae (a bacteria that causes respiratory infections).

Several factors increase a person’s risk of having a mesh infection. These include mesh design, type of surgery and preexisting health problems.

Mesh Design

Infections can occur with any type of mesh, but some mesh designs have higher rates of infection. For example, meshes made from materials such as extended polytetrafluoroethylene (ePTFE) and polyethylene terephthalate (polyester) are more likely to become infected.

Meshes made with a small pore size are more prone to infection. Bacteria hide in the small pores and immune cells can’t get to them to fight them.

Mesh with a pore size of 75 micrometers (one millionth of a meter) has the lowest risk for infection, according to a 2010 article by Drs. C.N. Brown and J.G. Finch published in Annals of the Royal College of Surgeons of England.

Type of Surgery

Studies show that laparoscopic hernia surgery has a lower risk of complications — including infection —than open repair, according to the American College of Surgeons.

Some studies also suggest that infection rates may be more common depending on the location of the hernia.

For example, infection caused 43 percent of 105 patients to have mesh removed from an abdominal hernia (ventral, flank) because of infection, according to a 2018 article by Dr. Rajeev Sharma and colleagues.

In contrast, 91 percent of patients who had hernias in the pelvis area (inguinal and others) had their mesh removed because of pain.

Preexisting Health Problems

A person’s risk for mesh infection goes up if they have preexisting health conditions. These include diabetes, abnormal wound or skin issues, immunosuppression, COPD and obesity.

People who smoke and have recurrent hernias also have a greater risk of developing an infection.

Recalled Mesh

According to the U.S. Food and Drug Administration, many of the reports of complications including pain and infection were associated with recalled mesh.

These products were also the main cause of bowel perforation and obstruction.

Treatment

The most effective treatment for hernia mesh infection is revision surgery — to remove all or part of the infected mesh — combined with intravenous antibiotics.

Antibiotics alone typically have a poor success rate because bacteria form a biofilm and a thick capsule around the mesh that protects them from antibiotics.

In some patients the surgical repair may be complicated, and more than one surgery may be necessary.

“When patients develop a mesh infection, most will require complete mesh excision and recurrent hernia repair.”

People who are unstable because of infection might not be able to undergo surgery immediately. In these cases, doctors will perform surgery to drain the infection before removing mesh.

Some doctors try to leave as much mesh in as possible because removing all the mesh may increase the risk that the hernia will return. In these cases, doctors will remove as much of the infected tissue as possible, drain the pus and flush the site out with saline/povidone-iodine.

Alternatives to surgery with synthetic mesh such as polypropylene include biologic mesh made from animal or human tissue and repair using the patient’s own tissue.

Litigation over Infection Complications

Thousands of patients who suffered from hernia mesh infection filed lawsuits against several mesh manufacturers, including Atrium, Bard Davol (C.R. Bard/Davol), Covidien Medtronic, Ethicon and W.L. Gore and Associates.

Patients claim manufacturers designed faulty hernia mesh implants and failed to warn them of the risk of infection and other serious complications that required revision surgery to fix.

As of April 15, 2021, mesh manufacturers face nearly 18,000 hernia mesh lawsuits in Georgia, New Hampshire and Ohio federal courts. Many more are pending in state court.

Please seek the advice of a medical professional before making health care decisions.