Bacterial colonisation of collagen-coated polypropylene vaginal mesh: are additional intraoperative sterility procedures useful?

Abstract
Introduction and hypothesis The use of vaginally implanted polypropylene meshes in the treatment of prolapse is becoming increasingly popular. We set out to detect how often bacterial colonisation of the mesh occurs and if the intraoperative sterility procedures that are applied matter. Methods In 64 consecutive women, bacterial colonisation was compared between two intraoperative sterility procedures. Culture swabs of the core mesh were taken during surgery, and the mesh arms removed at the end of surgery were cultured separately. Results Sixty-seven implants were cultured. In 56 (83.6%) implants, a positive culture with vaginal bacteria was found with very low bacterial density (<10^3 colony-forming units). No significant differences in bacterial species, density, clinical infection and erosion (two anterior and one posterior) were found between the two intraoperative sterility methods. Conclusions Colonisation of vaginally implanted mesh occurs frequently but in low bacterial densities, irrespective of the intraoperative sterility procedure used.