Mesh related complications：a clinical challenge requiring urgent attention in hernia surgery in China

doi:10.3877/cma.j.issn.1674-392X.2025.03.002

Abstract

Abstract:

The application of hernia mesh has significantly reduced postoperative recurrence rates. However， mesh related complications （MRC） have gradually emerged as a clinically significant concern. MRC is characterized by complex pathogenic mechanisms， diverse clinical manifestations， and variable treatment outcomes. Surgeons should enhance their understanding of MRC， standardize surgical techniques， and rationally select surgical approaches and mesh materials to minimize the occurrence of MRC to the greatest extent.

Key words: Mesh related complications, Hernia, Herniorrhaphy, Prevention

Cong Tong, Zeyu Li, Likun Yan. Mesh related complications：a clinical challenge requiring urgent attention in hernia surgery in China[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(03): 253-257.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2025.03.002

https://zhshfbwkzz.cma-cmc.com.cn/EN/Y2025/V19/I03/253

References 44

［1］	Li JF， Lai DD， Zhang XD， et al. Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty［J］. Can J Surg， 2012，55（1）：27-32.
［2］	Kokotovic D， Bisgaard T， Helgstrand F. Long-term Recurrence and Complications Associated With Elective Incisional Hernia Repair［J］.JAMA， 2016， 316（15）：1575-1582.
［3］	Bueno-Lledó J， Carreño-Sáenz O， Perez-Alonso C， et al. How can we predict or prevent late mesh infection in ventral hernia repair？：Description of the type of study：a retrospective comparative study［J］. Hernia， 2025， 29（1）：199.
［4］	Perez AR， Roxas MF， Hilvano SS. A randomized， double-blind，placebo-controlled trial to determine effectiveness of antibiotic prophylaxis for tension-free mesh herniorrhaphy［J］. J Am Coll Surg，2005， 200（3）：393-397.
［5］	Gillion JF， Palot JP. Abdominal wall incisional hernias：infected prosthesis：treatment and prevention［J］. J Visc Surg， 2012， 149 （5 Suppl）：e20-e31.
［6］	Carvalho AC， Santos FAV， De Carvalho Garcia DP. Meta-analysis of controlled studies comparing biologic and synthetic unabsorbable mesh in contaminated fields［J］. Surg Endosc， 2025， Online ahead of print.
［7］	HerniaSurge Group. International guidelines for groin hernia management［J］. Hernia， 2018， 22（1）：1-165.
［8］	Narkhede R， Shah NM， Dalal PR， et al. Postoperative Mesh Infection—Still a Concern in Laparoscopic Era［J］. Indian J Surg，2015， 77（4）：1-5.
［9］	Guillaume O， Pérez-Tanoira R， Fortelny R， et al. Infections associated with mesh repairs of abdominal wall hernias：Are antimicrobial biomaterials the longed-for solution？［J］. Biomaterials，2018， 167：15-31.
［10］	Brown RH， Subramanian A， Hwang CS， et al. Comparison of infectious complications with synthetic mesh in ventral hernia repair［J］. Am J Surg， 2013， 205（2）：182-187.
［11］	Guillaume O， Garric X， Lavigne JP， et al. Multilayer， degradable coating as a carrier for the sustained release of antibiotics：Preparation and antimicrobial efficacy in vitro［J］. J Control Release，2012， 162（3）：492-501.
［12］	Mehrabi Bahar M， Jabbari Nooghabi A， Jabbari Nooghabi M， et al.The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh［J］. Asian J Surg， 2015， 38（3）：139-144.
［13］	Engelsman AF， Van Dam GM， van der Mei HC， et al. In vivo evaluation of bacterial infection involving morphologically different surgical meshes［J］. Ann Surg， 2010， 251（1）：133-137.
［14］	孙斌杰，李云锋，余坤，等. 腹股沟疝术后慢性疼痛的诊疗进展［J］. 国际外科学杂志， 2021， 48（7）：493-499.
［15］	安丽娟，俞永江. 腹股沟疝修补术后慢性腹股沟疼痛危险因素的研究进展［J］. 中国普外基础与临床杂志， 2020， 27（5）：629-633.
［16］	Acar T， Gömceli I， Taçyildiz R， et al. Enterocutaneous fistula due to polypropylene mesh migration［J］. Ir J Med Sci， 2002， 171（3）：172-174.
［17］	Li J， Cheng T. Mesh erosion after hiatal hernia repair：the tip of the iceberg？［J］. Hernia， 2019， 23（6）：1243-1252.
［18］	Bliziotis IA， Kasiakou SK， Kapaskelis AM， et al. Mesh-related infection after hernia repair：case report of an emerging type of foreign-body related infection［J］. Infection， 2006， 34（1）：46-48.
［19］	Mann DV， Prout J， Havranek E， et al. Late-onset deep prosthetic infection following mesh repair of inguinal hernia［J］. Am J Surg，1998， 176（1）：12-14.
［20］	Taylor SG， O'Dwyer PJ. Chronic groin sepsis following tension-free inguinal hernioplasty［J］. Br J Surg， 1999， 86（4）：562-565.
［21］	Akyol C， Kocaay F， Orozakunov E， et al. Outcome of the patients with chronic mesh infection following open inguinal hernia repair［J］.J Korean Surg Soc， 2013， 84（5）：287-291.
［22］	唐黎明，费晓舟，孙一峰，等. 无张力腹股沟疝修补术后补片感染的探讨［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2013， 7（2）：64-67.
［23］	Delikoukos S， Tzovaras G， Liakou P， et al. Late-onset deep mesh infection after inguinal hernia repair［J］. Hernia， 2007， 11（1）：15-17.
［24］	朱本磊，刘付恒，周太成，等. 腹股沟疝术后感染补片取出手术方式探讨［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2025， 19（1）：63 -68.
［25］	Montgomery A， Kallinowski F， Köckerling F. Evidence for Replacement of an Infected Synthetic by a Biological Mesh in Abdominal Wall Hernia Repair［J］. Front Surg， 2016， 2：67.
［26］	邹振玉，曹金鑫，朱熠林，等. 腹腔镜腹股沟疝修补术后补片感染的外科治疗［J］. 中华消化外科杂志， 2023， 22（9）：1080-1085.
［27］	王帆，靳翠红，申英末，等. 腹股沟疝无张力修补术后补片感染的外科治疗策略［J］. 中华消化外科杂志， 2020， 19（10）：1070-1075.
［28］	Qimanguli S， Yiyao C， Juan W， et al. Abdominal wall hernia repair：from prosthetic meshes to smart materials［J］. Mater Today Bio， 2023，21：100691.
［29］	黄浩男，汤福鑫，马宁. 聚丙烯及其改性疝修补补片的研究进展［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2025， 19 （2）：150-154.
［30］	王俊毅，薛振峰. 可吸收补片在老年开放腹股沟疝患者中的应用［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2025， 19 （1）：88 -91.
［31］	Ding R， Yu L， Peng P， et al. Durable and Robust Antibacterial Polypropylene Hernia Mesh for Abdominal Wall Defect Repair［J］.ACS Appl Mater Interfaces， 2024， 16（20）：25686-25697.
［32］	Ding R， Peng P， Huo J， et al. pH-Responsive antibacterial metal-phenolic network coating on hernia meshes［J］. Biomater Sci，2024， 12（10）：2730-2742.
［33］	Grafmiller KT， Zuckerman ST， Petro C， et al. Antibiotic-releasing microspheres prevent mesh infection in vivo［J］. J Surg Res， 2016，206（1）：41-47.
［34］	Zhou HY， Zhang J， Yan RL， et al. Improving the antibacterial property of porcine small intestinal submucosa by nano-silver supplementation：a promising biological material to address the need for contaminated defect repair［J］. Ann Surg， 2011， 253（5）：1033-1041.
［35］	Majumder A， Scott JR， Novitsky YW. Evaluation of the Antimicrobial Efficacy of a Novel Rifampin/Minocycline-Coated，Noncrosslinked Porcine Acellular Dermal Matrix Compared With Uncoated Scaffolds for Soft Tissue Repair［J］. Surg Innov， 2016，23（5）：442-455.
［36］	Aljaiuossi A， Ba-Shammakh SA， Bani Hani M， et al. Inguinodynia following inguinal hernia repair：a comparative analysis of open Lichtenstein and laparoscopic TAPP techniques in a two-center cohort［J］. Front Surg， 2025， 12：1590855.
［37］	付文华，王培东. 电针治疗腹股沟疝术后慢性疼痛疗效观察［J］.世界最新医学信息文摘， 2019， 19（26）：135-136.
［38］	杨犇，刘飞，吴艳，等. 超声引导环腹股沟管注射治疗腹股沟疝术后慢性疼痛［J］. 中国疼痛医学杂志， 2022， 28（6）：474-476.
［39］	Moseholm VB， Baker JJ， Rosenberg J. Anatomical variations of the ilioinguinal， iliohypogastric， and genitofemoral nerves：a systematic scoping review of cadaver studies［J］. Hernia， 2025， 29（1）：191.
［40］	王平，黄永刚. 腹股沟疝术后慢性疼痛处理流程国际共识解读［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2018， 12（1）：6-9.
［41］	菅凤国，孙宏杰，刘国正，等. 猪小肠黏膜下层生物补片与人体真皮脱皮细胞基质补片应用于感染性腹壁缺损治疗中的效果及组织相容性影响分析［J］. 现代医学与健康研究， 2018， 2（8）：10， 12.
［42］	陈革，唐健雄，黄磊，等. 生物补片在治疗感染和污染腹壁缺损方面的体会（附34例病例）［J/OL］. 中华疝和腹壁外科杂志（电子版）， 2011， 5（4）：389-393.
［43］	Maskal SM， Ellis RC， Mali O， et al. Long-term mesh-related complications from minimally invasive intraperitoneal onlay mesh for small to medium-sized ventral hernias［J］. Surg Endosc， 2024，38（4）：2019-2026.
［44］	Hoffmann H， Köckerling F， Adolf D， et al. Analysis of 4，015 recurrent incisional hernia repairs from the Herniamed registry：risk factors and outcomes［J］. Hernia， 2021， 25（1）：61-75.

[1]	Zejin Zhang, Dawei Li, Yucong Li, Zhaoxing Liu, Chuan′an Shen. A review of fluid resuscitation in burn shock [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2025, 20(03): 254-259.
[2]	Shangjun Zhou, Ruibin Deng, Ping Zhan, Hai Huang, Yanqing Deng, Peijie Zhang, Huanbin Zhang, Xuelu Zhou. A propensity score matched comparison of plane dissection and telescopic dissection for totally extraperitoneal inguinal hernia repair [J]. Chinese Archives of General Surgery(Electronic Edition), 2025, 19(02): 101-105.
[3]	Jianxiong Tang, Shaojie Li. The current situation, problems and future of laparoscopic hernia surgery treatment in China [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 355-358.
[4]	Wen Tian, Xiaodong Yang. Difficulties and countermeasures in laparoscopic hernia surgery treatment in China [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 359-361.
[5]	Tao Li, Hanfang Zhu, Shiyong Li. Selection and principle of laparoscopic hernia repair in China [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 362-365.
[6]	Tao Li, Hanfang Zhu, Shiyong Li. Laparoscopic transabdominal preperitoneal repair of right inguinal hernia [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 366-366.
[7]	Yanling Zhao, Heng Wang, Qin Qin, Jing Li. Observation on the application of different surgeries in patients with esophageal hiatal hernia complicated with gastroesophageal reflux disease [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 421-424.
[8]	Ligang Nan, Junyan Wang, Xi Wu, Xiaojing Wu, Jiao Liang, Lei Guan, Xianglong Duan. Clinical efficacy study of open preperitoneal tension-free herniorrhaphy and laparoscopic transabdominal preperitoneal herniorrhaphy in elderly patients [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(03): 321-324.
[9]	Zhenling Ji, Zonghang Liu. How to repair the esophageal hiatus defect during hiatal hernia repair [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(03): 245-252.
[10]	Ning Ma, Taicheng Zhou, Shuang Chen. Prevention and treatment strategies for hemorrhagic complications in hernia surgery [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(02): 132-135.
[11]	Baoming Jia, Shuo Yang. Protection strategies for obturator vessels in hernia and abdominal wall surgery [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(02): 136-139.
[12]	Limin Liu, Zongming Zhang, Yue Zhao, Chong Zhang, Zhuo Liu, Hui Qi. Progress and current status of prevention and treatment of iatrogenic bile duct injury [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 346-353.
[13]	Minjie Lin, Chennan Xu, Zhiming Wu. Prevention and treatment of bleeding during laparoscopic hepatectomy [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 360-365.
[14]	Zhenhao Fei, Zhanghua Qiu, Zhiwei Sun, Junfeng Wang, Yesheng Chen, Jianzhong Tang. Experience of transumbilical single-port laparoscopic cholecystectomy combined with umbilical hernia repair [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(02): 270-273.
[15]	Yingjie Duan, Junxia Du, Xiaonan Ding, Qinqin Ren, Fei Chen, Chenwen Song, Mingwei Tian, Dong Zhang, Hanyu Zhu. Advances in pathogenesis and prevention and treatment of heat stress-induced kidney injury [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2025, 14(02): 97-103.

Please choose a citation manager

Content to export