Use of a New Silver-Impregnated Mesh for Incisional Hernia Surgery With Clean-Contaminated Wounds. First Case Series Results.

Aim: The incidence of surgical site infection (SSI) in incisional hernia surgery may vary from 10% to 33% in clean-contaminated fields. Although wide-pore polypropylene prostheses are described as being able to resist infection, they are not exempt from morbidity that can lead to a catastrophic scenario associated with high recurrence. To avoid these complications, there are new polypropylene prostheses embedded with silver ions with bactericidal effects. We present the first experience described with the use of this type of prosthesis in a case series of incisional hernia surgery in clean-contaminated fields.

Material And Methods: Single-center, retrospective, observational study on a prospectively collected sample of patients undergoing incisional hernia surgery in clean-contaminated fields. All patients who required ostomy reconstruction or bowel resection and had incisional hernia treated with silver-impregnated prostheses were included. Both procedures were performed in a single procedure using a silver ion-impregnated polypropylene mesh for wall surgery. Demographic data, hernia characteristics, surgical technique and follow-up data are collected. The results obtained in our series are described and compared with a similar previous series of our team using conventional polypropylene prostheses.

Results: From July 2022 to December 2024, 12 patients underwent surgery with clean-contaminated wounds subjected to midline incisional hernia surgery with Optilene Silver Mesh Elastic. Ten retromuscular repairs, one anterior component separation and one onlay repair were performed. The mean follow-up was 12 months, with no SSI or prosthesis explants. At follow-up, the control group presented SSI in 3 (27.3%) cases, compared to 0 cases in the silver mesh group, with differences close to statistical significance (p = 0.052). The rest of the follow-up variables did not show statistically significant differences.

Conclusions: The use of silver-impregnated polypropylene prostheses can be a safe alternative for use in clean-contaminated fields, with no SSI in our series.