Is Parietene mesh associated with a low risk of infection?

Parietene Mesh and Infection Risk

Parietene mesh is associated with a low risk of infection, particularly when used in clean or clean-contaminated surgical fields, with studies showing only 1 mesh infection in 16 implantations (6.25%) even in contaminated environments. 1

Infection Risk of Parietene Mesh in Different Surgical Fields

Clean and Clean-Contaminated Fields

• Parietene mesh demonstrates excellent performance in clean and clean-contaminated surgical fields
• The World Journal of Emergency Surgery guidelines support the use of synthetic mesh in clean-contaminated fields (CDC wound class II), noting that it can be performed "without any increase in 30-day wound-related morbidity" 2
• Synthetic meshes like Parietene are associated with significantly lower recurrence rates compared to non-mesh repairs 3

Contaminated Fields

• In experimental contaminated environments, Parietene showed strong resistance to infection with only one mesh infection occurring in 16 implantations (6.25%) 1
• This infection rate is significantly lower than other synthetic meshes tested in the same study, such as C-Qur (93.75%) and Dualmesh (46.7%) 1
• Recent meta-analysis shows that synthetic meshes are not associated with increased surgical site infection rates compared to biologic meshes in contaminated fields 4, 5

Comparative Performance

• When compared to other mesh types in contaminated environments:

  • Parietene outperforms C-Qur and Dualmesh in infection resistance 1
  • It shows comparable infection resistance to Parietene Composite, Sepramesh, Omyramesh, and the biological mesh Strattice 1
  • After 90 days, Parietene had 72.5% adhesion coverage, which was higher than some coated meshes but did not result in higher infection rates 1

• A 2020 study of 541 contaminated ventral hernia repairs found that permanent synthetic mesh placed in an extraperitoneal position had:

  • Lower surgical site infection rates (14.2%) compared to biologic mesh (36.8%) and absorbable synthetic mesh (32.7%) 6
  • Lower recurrence rates compared to biologic or bioabsorbable meshes 6

Clinical Applications

• Parietene PP, a specific design of Parietene mesh, has been developed for plug and patch groin hernia repair with preliminary results showing satisfactory outcomes 7
• The mesh's design helps prevent plug migration, which is a common concern with other plug and patch techniques 7

Recommendations for Use

• For clean or clean-contaminated surgical fields (CDC wound class I or II), Parietene mesh can be safely used with low infection risk 2, 3
• In contaminated fields (CDC wound class III), Parietene still demonstrates relatively low infection risk compared to many other synthetic meshes 1
• For dirty surgical fields (CDC wound class IV) or in cases of gross enteric spillage, guidelines still recommend biological mesh for defects >3cm, though recent evidence suggests synthetic meshes like Parietene may be viable alternatives 2, 4

Pitfalls and Caveats

• Proper surgical technique and mesh positioning are crucial for minimizing infection risk
• Extraperitoneal placement of synthetic mesh is associated with lower infection rates than intraperitoneal placement 6
• While Parietene shows good resistance to infection, it may have higher adhesion formation (72.5% coverage at 90 days) compared to some coated meshes 1
• Patient-specific factors such as immunosuppression, malnutrition, or diabetes may increase infection risk regardless of mesh type

Parietene mesh demonstrates a favorable infection risk profile compared to many other synthetic meshes, particularly when used in appropriate surgical fields with proper technique.