Abstract
Background
The innovative use of sterilized mosquito net as a cheaper alternative to commercial
mesh for hernia repair has gained increasing recognition. Developing health care systems
have inherently higher surgical site infection rates, and concerns regarding the introduction
of untested prosthetic hernia meshes have been raised. This in vitro study assesses the infection risk of polyethylene (PE) mosquito net mesh compared
with commercial hernia prosthetics by assessing the essential (first) step in the
pathogenesis of mesh infections.
Materials and methods
Individual meshes were inoculated with Staphylococcus epidermidis and Staphylococcus aureus with a bacterial inoculum of 102 bacteria. Inoculated meshes were incubated for 18 h in tryptone soy broth and then
analyzed using scanning electron microcopy. The final fraction of the bacteria adherent
to each of the meshes was compared. One-way analysis of variance was performed on
the bacterial counts. The Tukey test was used to determine the difference between
the different biomaterials in the event the one-way analysis of variance was significant.
Results
There was no significant difference in the mean number of adherent bacteria to PE
mosquito net compared with the monofilament polypropylene-based meshes (Prolene and
Bard Soft Mesh). Multifilament Vypro mesh had significantly greater mean bacterial
adherence compared with PE mosquito net (P < 0.001 with S aureus and P = 0.003 with S epidermidis).
Conclusions
In vitro infection risk of PE mosquito net is not significantly different from commonly used
monofilament polypropylene commercial prosthetics and is in fact lower than a commonly
used commercial multifilament mesh. This study adds to the growing body of evidence
that indicates that these meshes can be safely deployed.
Keywords
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Article info
Publication history
Published online: February 18, 2013
Accepted:
January 24,
2013
Received in revised form:
December 27,
2012
Received:
December 27,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
