期刊
HERNIA
卷 26, 期 5, 页码 1293-1299出版社
SPRINGER
DOI: 10.1007/s10029-022-02583-0
关键词
Hernia; Biofilms; Implant infection; Mesh failure; Mesh complication; Chronic pain; Staphylococcus aureus
类别
资金
- Royal Australasian College of Surgeons
- National Health and Medical Research Council [GNT1163634, GNT2004036]
- University of Adelaide
- Hospital Research Foundation, Australia
This study investigated the link between bacterial biofilms and negative outcomes of hernia repair surgery. The results suggest that staphylococci biofilms may contribute to hernia repair failure, chronic pain, and exacerbation of disease.
Purpose The purpose of this study was to investigate the link between bacterial biofilms and negative outcomes of hernia repair surgery. As biofilms are known to play a role in mesh-related infections, we investigated the presence of biofilms on hernia meshes, which had to be explanted due to mesh failure without showing signs of bacterial infection. Methods In this retrospective observational study, 20 paraffin-embedded tissue sections from explanted groin hernia meshes were analysed. Meshes have been removed due to chronic pain, hernia recurrence or mesh shrinkage. The presence and bacterial composition of biofilms were determined. First, specimens were stained with fluorescence in situ hybridisation (FISH) probes, specific for Staphylococcus aureus and coagulase-negative staphylococci, and visualised by confocal laser scanning microscopy. Second, DNA was extracted from tissue and identified by S. aureus and S. epidermidis specific PCR. Results Confocal microscopy showed evidence of bacterial biofilms on meshes in 15/20 (75.0%) samples, of which 3 were positive for S. aureus, 3 for coagulase-negative staphylococci and 9 for both species. PCR analysis identified biofilms in 17/20 (85.0%) samples, of which 4 were positive for S. aureus, 4 for S. epidermidis and 9 for both species. Combined results from FISH/microscopy and PCR identified staphylococci biofilms in 19/20 (95.0%) mesh samples. Only 1 (5.0%) mesh sample was negative for bacterial biofilm by both techniques. Conclusion Results suggest that staphylococci biofilms may be associated with hernia repair failure. A silent, undetected biofilm infection could contribute to mesh complications, chronic pain and exacerbation of disease.
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