Evidence map›Paper›PMID 32057193›Full record

SynthesisBJS open2020

Prevention of incisional hernia after midline laparotomy with prophylactic mesh reinforcement: a meta-analysis and trial sequential analysis.

A P Jairam, M López-Cano, J M Garcia-Alamino, J A Pereira, L Timmermans, J Jeekel, J Lange, F Muysoms

2 registry-linked trialsOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BJS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 41 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 10 pooled it
6.9field-weighted citation impact, top 2% 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.

NCT04700956 nacompletednot on this map

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
NCT07753551 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

PRophylactic mEsh Reinforcement Versus Primary Closure After Emergency Midline Laparotomy (PREEMPT): A Multicenter Randomized Clinical Trial

TypeinterventionalSponsorUniversity of Rome Tor VergataRan2026 to 2031Enrolled189ConditionsIncisional Hernia After Midline Laparotomy, Emergency Abdominal SurgeryArmsProphylactic Biosynthetic Mesh Placement, Direct suture
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 10 syntheses or guidelines pooled it, 63 citations in OpenAlex.

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  17. Incisional hernia prediction using machine learning models.BMC medical informatics and decision making · 2026
    Observational
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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

8 authors at 7 institutions in 4 countries.

A P JairamDepartment of Surgery, Catharina Hospital Eindhoven, Eindhoven, Netherlands.ORCID 0000-0002-1107-3120
M López-CanoDepartment of General and Digestive Surgery, Hospital Vall d'Hebrón, Universidad Autónoma de Barcelona, Barcelona, Spain.ORCID 0000-0003-3337-0756
J M Garcia-AlaminoDepartment of Primary Health Care Sciences, University of Oxford, Oxford, UK.
J A PereiraDepartment of General and Digestive Surgery, Hospital Del Mar, Barcelona, Spain.
L TimmermansDepartment of Surgery, Maasstad Ziekenhuis Rotterdam, Rotterdam, Netherlands.
J JeekelDepartment of General Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands.
J LangeDepartment of General Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands.
F MuysomsDepartment of Surgery, Maria Middelares Hospital, Ghent, Belgium.
Erasmus University Rotterdam · NLAZ Maria Middelares · BEHospital Del Mar · ESMaasstad Ziekenhuis · NLRadboud University Nijmegen · NLUniversitat Autònoma de Barcelona · ESUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncisional hernia is a frequent complication after abdominal surgery. The aim of this study was to assess the efficacy of prophylactic mesh reinforcement (PMR) after midline laparotomy in reducing the incidence of incisional hernia.

methodsA meta-analysis was conducted following PRISMA guidelines. The primary outcome was the incidence of incisional hernia after follow-up of at least 12 months. Secondary outcomes were postoperative complications. Only RCTs were included. A random-effects model was used for the meta-analysis, and trial sequential analysis was conducted.

resultsTwelve RCTs were included, comprising 1815 patients. The incidence of incisional hernia was significantly lower after PMR compared with sutured closure (risk ratio (RR) 0·35, 95 per cent c.i. 0·21 to 0·57; P < 0·001). Both onlay (RR 0·26, 0·11 to 0·67; P = 0·005) and retromuscular (RR 0·28, 0·10 to 0·82; P = 0·02) PMR led to a significant reduction in the rate of incisional hernia. The occurrence of seroma was higher in patients who had onlay PMR (RR 2·23, 1·10 to 4·52; P = 0·03). PMR did not result in an increased rate of surgical-site infection.

conclusionPMR of a midline laparotomy using an onlay or retromuscular technique leads to a significant reduction in the rate of incisional hernia in high-risk patients. Individual risk factors should be taken into account to select patients who will benefit most. [Correction added on 19 February 2020, after first online publication: J. García Alamino has been amended to J. M. Garcia-Alamino].

Indexed as

Surgical MeshAbdominal Wound Closure TechniquesAortic Aneurysm, AbdominalHernia, AbdominalHumansIncisional HerniaLaparotomyRandomized Controlled Trials as TopicSeromaSurgical Wound InfectionSuture TechniquesTreatment Outcome

Identifiers

PMID32057193
PMCPMC7260413
OpenAlexW3006544382

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.