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Despite a multitude of mesh appliances and techniques, no size fits all, and there is continued debate on what is the best mesh type, especially in high-risk patients with contaminated hernias. Infected mesh carries a significant burden to the patient, the surgeon and overall healthcare costs with medical legal implications. A stepwise approach that involves optimization of patient comorbidities, patient selective choice of mesh and technique is imperative in mitigating outcomes and recurrence rates. This review will focus on the avoidance of mesh infection and the selection of mesh in patients with contaminated wounds.<\/jats:p>","DOI":"10.1136\/tsaco-2024-001379","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T13:55:19Z","timestamp":1713189319000},"page":"e001379","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Meshing around: high-risk hernias and infected mesh"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3292-7877","authenticated-orcid":false,"given":"Natasha","family":"Keric","sequence":"first","affiliation":[{"name":"Surgery, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA"},{"name":"Surgery, Banner\u2014University Medical Center Phoenix, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Campbell","sequence":"additional","affiliation":[{"name":"Surgery, UCSF, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"2025081711114730000_9.Suppl_2.e001379.1","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1093\/bjs\/znac302","article-title":"Updated guideline for closure of abdominal wall incisions from the European and American hernia societies","volume":"109","author":"Deerenberg","year":"2022","journal-title":"British Journal of Surgery"},{"key":"2025081711114730000_9.Suppl_2.e001379.2","first-page":"969","article-title":"Use of Marlex mesh in the repair of an Incisional hernia","volume":"24","author":"USHER","year":"1958","journal-title":"Am Surg"},{"key":"2025081711114730000_9.Suppl_2.e001379.3","doi-asserted-by":"crossref","DOI":"10.1001\/archsurg.1960.01300050169030","article-title":"A new technique for the repair of Inguinal and Incisional Hernias","volume":"81","author":"Usher","year":"1960","journal-title":"Arch Surg"},{"key":"2025081711114730000_9.Suppl_2.e001379.4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.5694\/j.1326-5377.1952.tb75023.x","article-title":"A preliminary report on the use of prefabricated nylon weave in the repair of ventral hernia","volume":"1","author":"CUMBERLAND","year":"1952","journal-title":"Med J Aust"},{"key":"2025081711114730000_9.Suppl_2.e001379.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-002-0078-9"},{"key":"2025081711114730000_9.Suppl_2.e001379.6","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1177\/000313480907500905","article-title":"Infection risk of open placement of intraperitoneal composite mesh","volume":"75","author":"Cobb","year":"2009","journal-title":"Am Surg"},{"key":"2025081711114730000_9.Suppl_2.e001379.7","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2012.123"},{"key":"2025081711114730000_9.Suppl_2.e001379.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-004-8810-4"},{"key":"2025081711114730000_9.Suppl_2.e001379.9","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200565020-00003"},{"key":"2025081711114730000_9.Suppl_2.e001379.10","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b61d9a"},{"key":"2025081711114730000_9.Suppl_2.e001379.11","doi-asserted-by":"publisher","DOI":"10.22203\/eCM.v008a05"},{"key":"2025081711114730000_9.Suppl_2.e001379.12","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens2020288"},{"key":"2025081711114730000_9.Suppl_2.e001379.13","doi-asserted-by":"publisher","DOI":"10.1177\/039139880502801103"},{"key":"2025081711114730000_9.Suppl_2.e001379.14","doi-asserted-by":"crossref","first-page":"163","DOI":"10.4321\/S1137-66272005000300002","article-title":"Bacterial Biofilms and infection","volume":"28","author":"Lasa","year":"2005","journal-title":"An Sist Sanit Navar"},{"key":"2025081711114730000_9.Suppl_2.e001379.15","doi-asserted-by":"publisher","DOI":"10.4161\/viru.2.5.17724"},{"key":"2025081711114730000_9.Suppl_2.e001379.16","doi-asserted-by":"publisher","DOI":"10.1006\/jsre.2000.5981"},{"key":"2025081711114730000_9.Suppl_2.e001379.17","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jss.2005.06.020","article-title":"Gold and gold-palladium coated polypropylene grafts in a S. 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