微生物および生化学技術ジャーナル

概要

Innovative Modifications for Preventing Mesh Infections

Aydinuraz K

Ventral hernia repair is a field of on-going multidisciplinary scientific research, focusing mainly on creating different prosthetic materials. In daily surgical practice, it is almost impossible to think of an incisional hernia repair without using prosthetic mesh as there has been a significant decrease in hernia recurrence with the incorporation of prosthetic mesh in abdominal wall repairs in the last decades. Mesh infection is a feared complication of prosthetic mesh repairs. It eventually leads to the removal of the mesh and starts the vicious cycle of recurrent incisional hernia repairs. Antibiotic prophylaxis has contradictory results, which raise concern about reaching the minimal inhibitory concentration in the wound before biofilm is produced by bacteria. Modification of mesh texture and changing surface properties by loading the mesh surface with quaternary ammonium compounds, antimicrobial enzymes, antibiotics, triclosan, chitosan, polycations, antimicrobial polymers, silver nanoparticles, nitric oxide have resulted in newly synthesized mesh materials which inhibit biofilm formation and kill bacteria with better surgical outcomes. In the era of multi drug resistant bacteria, nanotechnologic innovations like photodynamic inactivation, fullerenes, carbon nanotubes are promising antibacterial solutions for mesh infections.