Effect of intraperitoneal and extraperitoneal insertion of mesh on bacterial translocation: Does it make a difference?

Abstract

Objective: To asses the effect of insertion of mesh, with or without contact with the peritoneum, on the induction of bacterial translocation. Design: Open experimental study. Setting: Surgical research laboratory, Turkey. Subjects: 158 Swiss albino mice. Interventions: A defect in the abdominal wall was created. In the control group, the defect was closed primarily. In the extraperitoneal group, polypropylene mesh was sutured over the abdominal wall after primary closure of the peritoneum and in the intraperitoneal group, polypropylene mesh was sutured to close the created defect so that it was in contact with the intestines. Main outcome measures: Bacterial translocation at 4, 24 and 48 hours. Results: Insertion of mesh in contact with the peritoneum led to increased bacterial translocation to mesenteric lymph nodes at 4 (p=0.02) and 48 (p=0.03) hours compared with insertion without contact. Conclusion: Contact between a foreign body and the peritoneum is required to induce bacterial translocation.