Mesh Infection After Hernioplasty: Complete vs Partial Removal - Retrospective Study on Outcomes and Pathogen Analysis

A Retrospective Study: Complete vs Partial Mesh Removal for Mesh Infection After Hernioplasty - Clinical Outcomes and Pathogen Analysis

Background: Mesh infection after tension-free inguinal hernia repair (IHR) is rare and challenging. When conservative treatment fails, surgery is often required. This study compared clinical outcomes of complete versus partial mesh removal in affected patients.

Materials and Methods: We retrospectively analyzed patients who underwent surgery for mesh infection after IHR in our hospital between January 2016 and December 2025. Baseline data, perioperative indicators, postoperative complications, and microbiological results were compared between the complete and partial removal groups.

Study Overview

• Status: Not yet recruiting
• Conditions: Inguinal Hernia Repair; Mesh Infection
• Intervention / Treatment: Procedure: Complete mesh removal; Procedure: Partial mesh removal

Detailed Description

We conducted a single-center, retrospective case series analysis. We included patients who developed mesh infection after tension-free IHR and underwent surgical treatment at our center between January 2016 and December 2025. Patients with mesh infection after incisional, parastomal, or umbilical hernia repair were excluded. We also excluded patients who improved with conservative treatment and did not undergo surgery.

We collected the following data: demographic characteristics, comorbidities, laboratory and imaging results, characteristics of the primary hernia surgery, infection characteristics, intraoperative data, and postoperative outcomes. All data were entered into a standardized database. Follow-up was conducted through outpatient visits and telephone interviews. The last follow-up was on October 30, 2025.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: Xiaoyu Peng, MD; Phone Number: +8619121706827; Email: 23211280025@m.fudan.edu.cn

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of patients who developed mesh infection after tension-free inguinal hernioplasty and subsequently underwent surgical mesh removal (either complete or partial) at our institution. Data were collected retrospectively from medical records, including demographic characteristics, comorbidities, laboratory and imaging results, primary hernia surgery details, infection characteristics, intraoperative data, and postoperative outcomes. Follow-up was conducted through outpatient visits and telephone interviews, with the last follow-up on October 30, 2025.

Description

Inclusion Criteria:

1. Patients who underwent tension-free inguinal hernioplasty with mesh placement.
2. Patients diagnosed with mesh infection requiring surgical re-intervention.
3. Patients who underwent complete or partial mesh removal surgery.
4. Availability of complete medical records and follow-up data.

Exclusion Criteria:

1. Patients with mesh infection managed conservatively (without surgical removal).
2. Patients with missing critical data (e.g., intraoperative findings, pathogen results, or follow-up).
3. Patients with concomitant procedures that could confound outcomes (e.g., simultaneous other hernia repair).
4. Patients lost to follow-up immediately after discharge (no postoperative assessment).

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
The complete mesh removal group	Procedure: Complete mesh removal; Total explantation of the entire prosthetic mesh, including all visible portions and fixation sutures, regardless of the extent of infection.
The partial mesh removal group	Procedure: Partial mesh removal; Excision of only the infected or non-incorporated portion of the mesh, with preservation of the well-incorporated, uninfected segment left in situ.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hernia Recurrence Rate	Presence of clinically or radiologically confirmed recurrent inguinal hernia at the site of previous hernioplasty following mesh removal surgery.	From date of surgery to December 2025
Infection Recurrence Rate	Recurrence of surgical site infection at the same location after initial surgical treatment for mesh infection, confirmed by clinical signs (e.g., erythema, purulent drainage, sinus tract formation) and/or positive microbiological culture.	From date of surgery to December 2025

Collaborators and Investigators

• Sponsor: Fudan University

Study record dates

Study Major Dates

• Study Start (Estimated): March 18, 2026
• Primary Completion (Estimated): May 31, 2026
• Study Completion (Estimated): July 31, 2026

Study Registration Dates

• First Submitted: March 18, 2026
• First Submitted That Met QC Criteria: March 18, 2026
• First Posted (Actual): March 24, 2026

Study Record Updates

• Last Update Posted (Actual): March 24, 2026
• Last Update Submitted That Met QC Criteria: March 18, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Inguinal hernia repair; mesh infection; complete mesh removal; partial mesh removal
• Other Study ID Numbers: HuadongHosptialHernia02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No