Evidence map›Paper›PMID 34006282›Full record

ArticleBMC surgery2021

Long-term follow-up of prophylactic mesh reinforcement after emergency laparotomy. A retrospective controlled study.

A Bravo-Salva, N Argudo-Aguirre, A M González-Castillo, E Membrilla-Fernandez, J J Sancho-Insenser, L Grande-Posa, M Pera-Román, J A Pereira-Rodríguez

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04578561 (Long-term Follow-up of Prophylactic Mesh Reinforcement After Emergency Laparotomy.), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT04578561 completednot on this map

Long-term Follow-up of Prophylactic Mesh Reinforcement After Emergency Laparotomy.

TypeobservationalSponsorJosé A. PereiraRan2010 to 2020Enrolled187ConditionsPrevention of Incisional Hernia in Emergency SurgeryArmsProphylactic mesh use
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Observational
  5. Observational
  6. Article
  7. Incisional Hernia Depends on More Than Just Mesh Placement.Journal of abdominal wall surgery : JAWS · 2024
    Article
  8. Defining High-Risk Patients Suitable for Incisional Hernia Prevention.Journal of abdominal wall surgery : JAWS · 2023
    Article
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.

A Bravo-SalvaServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain.
N Argudo-AguirreServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain.
A M González-CastilloServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain.
E Membrilla-FernandezServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain.
J J Sancho-InsenserServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain.
L Grande-PosaServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain.
M Pera-RománServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain.
J A Pereira-RodríguezServicio de Cirugía General Y del Aparato Digestivo, Parc de Salut Mar, Hospital del Mar, P. Marítim 23-25, 08003, Barcelona, Spain. jose.pereira@upf.edu.ORCID http://orcid.org/0000-0003-2457-6955

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevention of incisional hernias with a prophylactic mesh in emergency surgery is controversial. The present study aimed to analyze the long-term results of prophylactic mesh used for preventing incisional hernia after emergency midline laparotomies.

methodsThis study was a registered (NCT04578561) retrospective analysis of patients who underwent an emergency midline laparotomy between January 2009 and July 2010 with a follow-up period of longer than 2 years. Long-term outcomes and risk factors for the development of incisional hernias between patients who received a prophylactic reinforcement mesh (Group M) and suture (Group S) were compared.

resultsFrom an initial 266 emergency midline laparotomies, 187 patients were included. The median follow-up time was 64.4 months (SD 35). Both groups had similar characteristics, except for a higher rate of previous operations (62 vs. 43.2%; P = 0.01) and operation due to a revision laparotomy (32.5 vs.13%; P = 0.02) in the M group. During follow-up, 29.9% of patients developed an incisional hernia (Group S 36.6% vs. Group M 14.3%; P = 0.002). Chronic mesh infections were diagnosed in 2 patients, but no mesh explants were needed, and no patient in the M group developed chronic pain. Long-term risk factors for incisional hernia were as follows: smoking (HR = 2.47; 95% CI 1.318-4.624; P = 0.05), contaminated surgery (HR = 2.98; 95% CI 1.142-7.8; P = 0.02), surgical site infection (SSI; HR = 3.83; 95% CI 1.86-7.86; P = 0.001), and no use of prophylactic mesh (HR = 5.09; 95% CI 2.1-12.2; P = 0.001).

conclusionIncidence of incisional hernias after emergency midline laparotomies is high and increases with time. High-risk patients, contaminated surgery, and surgical site infection (SSI) benefit from mesh reinforcement. Prophylactic mesh use is safe and feasible in emergencies with a low long-term complication rate.

trial registrationNCT04578561. www.clinicaltrials.gov.

Indexed as

Incisional HerniaLaparotomyEmergenciesFollow-Up StudiesHumansRetrospective StudiesSurgical MeshContaminated surgery and long-term follow upEmergency SurgeryHernia preventionProphylactic mesh

Identifiers

PMID34006282
PMCPMC8130379

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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.