The repair of an abdominal wall hernia, which includes inguinal, ventral, incisional, femoral, umbilical, and paraumbilical hernias, is a generally clean procedure with a low risk of infectious complications. Wound infections following a hernia repair are a significant risk factor for hernia recurrence [1,2]. (See "Infection in mesh graft following hernia repair: Clinical manifestations, diagnosis, and treatment".)
The risk factors and strategies to reduce the risk of infection after an inguinal and ventral abdominal wall hernia repair will be reviewed here. An overview of control measures to prevent surgical site infection (SSI) and control measure controversies are discussed elsewhere. (See "Antimicrobial prophylaxis for prevention of surgical site infection in adults" and "Adjunctive measures for prevention of surgical site infection in adults".)
A number of clinical and technical factors have been identified that increase the risk of wound infection following an abdominal wall hernia repair, including clinical and intraoperative factors, use of mesh, location of mesh insertion, technique of hernia repair, use of drains, and emergent indications for procedure. Prior wound infections are also a risk factor since they are associated with a greater than 80 percent risk of hernia recurrence [1,2].
Clinical predictors — Clinical risk factors associated with a wound infection in a hernia repair include [1,3-7]:
- Heart failure
- Chronic obstructive pulmonary disease