dc.contributor.author
Lee, Lucas D.
dc.contributor.author
Stroux, Andrea
dc.contributor.author
Nickisch, Daniela
dc.contributor.author
Wröbel, Lea
dc.contributor.author
Aschenbrenner, Katja
dc.contributor.author
Weixler, Benjamin
dc.contributor.author
Kreis, Martin E.
dc.contributor.author
Lauscher, Johannes C.
dc.date.accessioned
2022-01-17T14:33:22Z
dc.date.available
2022-01-17T14:33:22Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/33597
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-33318
dc.description.abstract
Background: The safety of synthetic mesh in elective hernia repair in the setting of immunosuppression lacks national and international consensus. The aim of our analysis was to explore the effects of immunosuppression on the rates of wound complications.
Methods: Comparative analysis of immunocompetent and immunocompromised patients with elective mesh repair of inguinal, femoral, primary ventral, incisional or parastomal hernia between January 2001 and December 2013. Immunosuppression included glucocorticoids, biologicals, chemotherapy and chemoradiotherapy. Primary outcome parameter was mesh infection rate. Follow-up questionnaires were completed in written form or by telephone interview.
Results: Questionnaire response rate was 59.5% (n= 194) with a median follow-up of 33 (interquartile range: 28-41) months. There were no differences between immunocompromised (n= 40, 20.6%) and immunocompetent patients (n= 154, 79.4%) based on hernia and patient characteristics. Immunosuppression was not associated with the rates of mesh infection (P= 1.000), surgical site infection (SSI,P= 0.330) or re-operation for SSI (P= 0.365), but with higher rates (P= 0.007) and larger odds for hernia recurrence (odds ratio 3.264, 95% confidence interval 1.304-8.172;P= 0.012). Mesh infection also increased the odds for hernia recurrence (odds ratio 11.625; 95% confidence interval 1.754-77.057;P= 0.011). Only in the subset of ventral/incisional hernias, immunocompromised (n= 8, 40%) patients had higher recurrence rates than immunocompetent patients (n= 5, 11.6%;P= 0.017). Patients with SSI reported more frequently moderate to severe dysesthesia at the surgical site (P= 0.013) and would less frequently re-consent to surgery (P= 0.006). Conclusion Immunosuppression does not increase the rate of wound infections after elective hernia repair with synthetic mesh. However, immunosuppression and mesh infection are risk factors for hernia recurrence.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
herniorrhaphy
en
dc.subject
immunosuppression
en
dc.subject
surgical mesh
en
dc.subject
surgical wound infection
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Operative outcome of hernia repair with synthetic mesh in immunocompromised patients
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1111/ans.16212
dcterms.bibliographicCitation.journaltitle
ANZ Journal of Surgery
dcterms.bibliographicCitation.number
11
dcterms.bibliographicCitation.originalpublishername
Wiley
dcterms.bibliographicCitation.pagestart
2248
dcterms.bibliographicCitation.pageend
2253
dcterms.bibliographicCitation.volume
90
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
DEAL Wiley
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
32783324
dcterms.isPartOf.issn
1445-1433
dcterms.isPartOf.eissn
1445-2197