For the most part, prosthetic mesh works and does its job; however, when it becomes a problem, it usually becomes a BIG problem. The worst problem of all is when the mesh becomes infected. In that situation, with rare exception, the mesh must be removed--completely. It must be completely removed because any portion that remains may harbor bacteria which the body cannot clear away (even with the most powerful antibiotics), leading to a chronic wound, deeper infection, absesses, or systemic infection.
The treatment of infected mesh requires a step-wise approach with the first step in removing the mesh and debriding (cleaning) the wound. This step may be repeated multiple times until the area is clean. Once deemed clean, the area that the mesh covered will need to be reconstructed, preferably with your own tissue (flaps), or in combination with a Biologic mesh that can grow with your tissues and that your body ultimately recognizes as "self" tissue. It will take at least 6 weeks from the time of the final reconstruction to fully heal, and depending on the complexity of the wound, infection, and anatomy of the infected mesh, several months in total.
Far too often, I have seen patients who have lived with this problem for too long. A small, chronic wound, may be a sign of a much bigger problem deep down below. Appropriate evaluation, diagnosis, and management is critical, but just as importantly, it is important to first recognize and know that you may have mesh in your body. If it is close to an area that is draining or infected, the mesh must be ruled out as a potential source of problem. Afterward, it may be necessary to find a team of surgeons, including a general surgeon and plastic surgeon, to work together to solve this difficult problem.