Monday, February 15, 2021

Risk factors after hernia repair

 Q: 62 years old female is admitted to ICU with septic shock. Patient was found to have a mesh infection with her previous ventral wall hernia repair. Name few risk factors for infections after hernia repair?

Answer: Hernia repair is usually an uncomplicated surgery. At the same time, there is a long list of risk factors for its complications. The objective of this question is to mention some of the risk factors: 

  • Old age
  • Obesity 
  • Low serum albumin 
  • Diabetes 
  • Smoking
  • Immunosuppression 
  • Chronic steroid use
  • CHF
  • Underlying COPD
  • ASA score >3 
  • History of  MRSA infection
  • Emergency procedure 
  • Prolonged operative time 
  • Enterotomy or bowel resection done during repair
  • Perioperative blood transfusion 
  • Use of mesh to repair large ventral hernia defects >10 cm



1. Finan KR, Vick CC, Kiefe CI, et al. Predictors of wound infection in ventral hernia repair. Am J Surg 2005; 190:676. 

2. Mavros MN, Athanasiou S, Alexiou VG, et al. Risk factors for mesh-related infections after hernia repair surgery: a meta-analysis of cohort studies. World J Surg 2011; 35:2389. 

3. Stremitzer S, Bachleitner-Hofmann T, Gradl B, et al. Mesh graft infection following abdominal hernia repair: risk factor evaluation and strategies of mesh graft preservation. A retrospective analysis of 476 operations. World J Surg 2010; 34:1702. 

4. Ousley J, Baucom RB, Stewart MK, et al. Previous Methicillin-Resistant Staphylococcus aureus Infection Independent of Body Site Increases Odds of Surgical Site Infection after Ventral Hernia Repair. J Am Coll Surg 2015; 221:470.

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