Is Synecore mesh resistant to infection?

Synecore Mesh Infection Resilience

Synecore mesh demonstrates significant resilience to infection with a low mesh infection rate of only 1.4%, and importantly, no mesh infections requiring full explantation in clinical studies. 1

Mesh Infection Risk Factors

Mesh infection is a serious complication of hernia repairs that occurs in approximately 1.9-5% of cases 2, 3. Several factors increase the risk of mesh infection:

• Patient-related factors:

  • Steroid or immunosuppressive drug use (OR 2.22) 2
  • Urgent repair (OR 5.06) 2
  • Postoperative surgical site infection (OR 2.9) 2

• Procedure-related factors:

  • Mesh type (OR 3.13) 2
  • Onlay position (OR 3.51) 2
  • Associated enterotomy during procedure (OR 5.17) 2

Synecore Mesh Performance

Recent evidence specifically evaluating GORE Synecor™ mesh in ventral hernia repair demonstrates:

• Overall mesh infection rate of only 1.4% 1
• No mesh infections requiring full explantation 1
• Low hernia recurrence rate of 5.0% 1
• Favorable safety profile across various defect sizes and mesh placement locations 1

Mesh Selection in Contaminated Fields

The choice of mesh in contaminated surgical fields has been debated:

• Traditionally, biological meshes were preferred in contaminated settings due to perceived infection resistance 2
• Recent evidence shows synthetic meshes may perform equally well or better than biological meshes in contaminated fields 4, 5
• A 2024 meta-analysis found synthetic mesh had significantly lower recurrence rates compared to biological mesh in contaminated fields, with similar surgical site infection rates 5

Pathogenesis of Mesh Infection

Mesh infection involves complex interactions between:

• Bacterial virulence
• Surface physicochemical properties of the prosthetic material
• Host defense mechanisms 2

The primary concern is biofilm formation, where bacteria become embedded in self-secreted extracellular polymeric substances, creating an effective barrier against host immune cells and antibiotics 2, 6.

Management of Mesh Infections

If mesh infection occurs despite Synecore's resilience:

1. Conservative management: Early antibiotics and mechanical scrubbing/irrigation to remove biofilm before consolidation 2
2. Surgical management: If conservative treatment fails, complete surgical removal of the mesh may be necessary to prevent recurrent infections, visceral adhesions, and fistulae 2

Clinical Implications

When considering Synecore mesh for hernia repair:

• The low infection rate (1.4%) and absence of infections requiring complete mesh removal suggest excellent infection resilience 1
• Synecore appears to perform well even in higher-risk scenarios, with favorable outcomes across different placement techniques 1
• Proper surgical technique remains essential to minimize infection risk, including avoiding enterotomy and minimizing operative time 3

Caution

Despite Synecore's promising infection resilience:

• All mesh materials carry some infection risk as foreign bodies
• Proper aseptic technique remains critical, as even slight breaches in sterility can lead to biofilm formation 7
• Early recognition and treatment of mesh-related complications are essential to prevent progression to chronic infection requiring mesh removal 3