“The management of CMIs involves treatment strategies that range from conservative approaches, such as antibiotics and local wound care, to more aggressive interventions,
including partial mesh removal (PMR) or complete mesh removal (CMR). Recent advances advocate for mesh-preserving techniques including meticulous wound irrigation, local antiseptics, and vacuum-assisted closure that may facilitate healing without mesh removal, thus reducing morbidity associated with AWHR.”
“The main objective of this article proposes a comprehensive protocol for managing CMIs in AWHR, synthesising our experience about this treatment after 20 years and evidence from recent clinical studies and addressing key management controversies. This algorithm aspires to standardise care practices, reduce treatment failures, and improve patient outcomes in this challenging complication.”

“CMI following AWHR remains one of the most challenging complications in hernia surgery, despite advances in surgical techniques and materials. The establishment of an algorithm incorporating these insights is critical to improving clinical outcomes and optimising mesh infection management. Implementing such a protocol may harmonise care, reduce unnecessary mesh excisions, improve antimicrobial use, and ultimately enhance patient outcomes while managing healthcare resources efficiently.”

Bueno-Lledó J, Carreño-Sáenz O, Martinez-Hoed J, Bonafé-Diana S, Pous-Serrano S. A practical algorithm for the management of mesh infection in abdominal wall surgery: learnings after 20 years of experience. Hernia. 2026 Mar 6;30(1):115. Full Text for Emory Users