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

Objective: To asses the effect of insertion of mesh, with or without contac t 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 g roup, the defect was closed primarily. In the extraperitoneal group, polypr opylene mesh was sutured over the abdominal wall after primary closure of t he peritoneum and in the intraperitoneal group, polypropylene mesh was sutu red to close the created defect so that it was in contact with the intestin es. 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 t o induce bacterial translocation.