Background: Mesh repair is now the gold standard technique of repair on incisional hernias. Infection of the 
mesh is a challenging complication of this type of repair. The risk of mesh infection has been shown to be 
greater in case of complicated hernia.
Incarceration of inguinal, umbilical and cicatricial hernias is a frequent problem. However, little is known 
about the relationship between the use of mesh and outcome after surgery. The goal of this study was to 
describe the relationship between the use of mesh in incarcerated hernia and the clinical outcome.
Patients and Methods: Correspondence, operation reports and patient files between January 2010 and 
December 2012 of patients presented at two hospitals in sohag and Assuit were searched for cases of: 
incarceration, strangulation and hernia. The patient characteristics, clinical presentation, pre-operative 
findings and clinical course were scored and analysed.
Results: A total of 183 patients could be identified: 68 inguinal, 48 umbilical, 35 incisional, 13 epigastric, 13 
femoral, 3 trocar and 3 Spigelian hernias. In the statistical analysis, epigastric, femoral, trocar and Spigelian 
hernias were pooled, due to their small group sizes. One patient was excluded from the analysis because the 
hernia was not corrected during operation. In total, 90 hernias were repaired using mesh versus 92 primary 
suture repairs.
22 wound infections were registered (7%). One mesh was removed during a reintervention for anastomotic 
leakage, although no signs of wound infection were present. Nine patients died, none of them due to woundrelated problems one cardiovascular, one ruptured aneurysm, three pulmonary complications, two 
anastomotic leakage, two sepsis of unknown origin) Univariate analysis showed that female patients 
(P = 0.007), adipose patients (P = 0.016), patients with an umbilical hernia (P = 0.01) and patients who 
underwent a bowel resection (P = 0.015) had a significantly higher rate of wound infections. The type of 
repair (e.g. primary suture or mesh), use of antibiotic prophylaxis, gender, ASA (American Society of 
Anesthesiologists) class and age showed no significant relation with post-operative wound infection. After 
logistic regression analysis, only bowel resection (P = 0.020) showed a significant relation with post-operative 
wound infection.
Conclusions: Wound infection rates are high after the correction of acute hernia, but clinical consequences are 
relatively low. Mesh correction of an acute hernia seems to be safe and should be considered in every 
incarcerated hernia.