Bacterial biofilm as a risk factor for infectious complications in the use of polypropylene endoprostheses in surgery of anterior wall hernias

Objective. To analyze data on synthetic prostheses used in herniology, features of the body’s reaction to their implantation, possible infectious complications, and to search for ways to solve identified problems. Materials and methods . An analysis of publications in the PubMed, Web of Science, Elibrary and CyberLeninka systems was carried out, describing the use of synthetic prostheses for hernioplasty and the nature of complications in the postoperative period. The following search terms were used: “synthetic prostheses”, “tension-free hernioplasty”, “bacterial biofilm”, “infectious complications of hernioplasty”. A total of 38 original publications were selected. Results . The materials used for tension-free hernioplasty and their physical and mechanical properties were studied. The concept of bacterial biofilm was studied as one of the reasons for maintaining infectious complications on mesh endoprosthesis. Conclusion . Currently, the use of synthetic prostheses in operations on hernias of the anterior abdominal wall is the “gold standard”. The material of choice for the manufacture of endoprostheses is polypropylene. The elasticity of the polypropylene mesh is close to the physiological elasticity of the anterior abdominal wall. The polypropylene mesh consists of monofilament threads that do not have capillarity and wicking. In response to implantation, the polypropylene mesh causes a weak inflammatory reaction of soft tissues. At the same time, the use of polypropylene meshes in hernioplasty in comorbid patients, patients with strangulated hernias can lead to postoperative infectious complications, which is associated with the formation of a biofilm on the surface of the endoprosthesis. The development of a polymer coating for a mesh polypropylene prosthesis with prolonged release of antibiotics to delay bacterial colonization and the formation of a bacterial biofilm in conditions of bacterial contamination of the surgical field is relevant.