Evidence map›Paper›PMID 23712289›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2013

Systematic review and meta-analysis of prophylactic mesh placement for prevention of incisional hernia following midline laparotomy.

A Bhangu, J E Fitzgerald, P Singh, N Battersby, P Marriott, T Pinkney

3 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 36 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 8 pooled it
5.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03148496 naterminatednot on this mapstarted 2017, after this paper: background citation

Tissue Reinforcement of Incisional Closure Among High Risk Patients

TypeinterventionalSponsorThe University of Texas Health Science Center, HoustonRan2017 to 2021Enrolled163ConditionsWound ComplicationArmsBiologic Mesh, Small Bites, Large Bites
NCT04134455 nacompletednot on this mapstarted 2022, after this paper: background citation

The Mesh-RTL Project for Prevention of Incisional Hernia: Clinical Trial of Non-inferiority to Compare Two Aponeurotic Closure Techniques in Midline Laparotomy in Patients With Elevated Risk for Hernia

TypeinterventionalSponsorHospital Regional de Alta Especialidad del BajioRan2022 to 2022Enrolled250ConditionsHernia IncisionalArmsMesh reinforcement, RTL reinforcement
NCT04700956 nacompletednot on this mapstarted 2020, after this paper: background citation

Does Prophylactic Mesh Placement in Emergency Midline Laparotomy Reduce the Incidence of Incisional Hernia? A Prospective Randomized Clinical Trial

TypeinterventionalSponsorKonya City HospitalRan2020 to 2022Enrolled104ConditionsIncisional HerniaArmsprimary abdominal closure, abdominal closure with prophylactic mesh
3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 8 syntheses or guidelines pooled it, 87 citations in OpenAlex.

  1. Pooled it
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  8. European Hernia Society guidelines on the closure of abdominal wall incisions.Hernia : the journal of hernias and abdominal wall surgery · 2015
    Guideline
  9. Trial
  10. Trial
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  12. Long-term results of a prospective randomized trial of midline laparotomy closure with onlay mesh.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Trial
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  15. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

A BhanguAcademic Department of Surgery, Room 29, 4th Floor, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, UK. aneelbhangu@doctors.org.uk
J E Fitzgerald
P Singh
N Battersby
P Marriott
T Pinkney
Queen Elizabeth Hospital · GBQueen Elizabeth Hospital Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIncisional hernia is a common long-term complication after laparotomy. This study investigated whether prophylactic mesh reinforcement of laparotomy reduced the rate of incisional hernia, with emphasis on trial design and quality.

methodsA systematic review of published literature was performed for studies comparing incisional hernia presence following conventional closure or prophylactic mesh reinforcement. Studies were assessed using the Cochrane Risk of Bias Tool, the Jadad score and the Newcastle Ottawa Scale (NOS). The primary endpoint was incisional hernia, assessed by meta-analysis.

resultsSeven studies [four randomised controlled trials (RCTs) and three prospective trials] included 588 patients; 262 received mesh reinforcement. All studies included elective patients at high risk of incisional hernia. Six incorporated a polypropylene mesh and one a biologic mesh. Four studies were judged high quality by NOS and two of four RCTs were at low risk of bias, although overall outcome assessment from all studies was either poor or mediocre. Mesh significantly reduced the rate of incisional hernia [odds ratio (OR) 0.15, p < 0.001]; the same effect was seen in RCTs only (OR 0.17, p < 0.001). A borderline increase of seroma seen with a fixed effect model (OR 1.82, p = 0.050) was not seen with a random effect model (OR 1.86, p = 0.210, I (2) = 45 %).

conclusionMesh reinforcement of laparotomy significantly reduced the rate of incisional hernia in high-risk patients. However, poor assessment of secondary outcomes limits applicability; routine placement in all patients cannot yet be recommended. More evidence regarding the rates of adverse events, cost-benefits and quality of life are needed.

Indexed as

Surgical MeshHernia, VentralHumansLaparotomy

Identifiers

PMID23712289
OpenAlexW2045402107

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.