ArticleHernia : the journal of hernias and abdominal wall surgery2022
Implementing a protocol to prevent incisional hernia in high-risk patients: a mesh is a powerful tool.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Prophylactic mesh augmentation in emergency laparotomy closure: a meta-analysis of randomized controlled trials with trial sequential analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Pooled it
- Updated guideline for closure of abdominal wall incisions from the European and American Hernia Societies.The British journal of surgery · 2022Pooled it
- Does onlay mesh placement in emergency laparotomy prevent incisional hernia? A prospective randomized double-blind study.Hernia : the journal of hernias and abdominal wall surgery · 2023Trial
- Incisional hernia prevention in high-risk midline laparotomy using onlay PVDF mesh: multicenter prospective observational study.Journal of abdominal wall surgery : JAWS · 2026Article
- Defining High-Risk Patients Suitable for Incisional Hernia Prevention.Journal of abdominal wall surgery : JAWS · 2023Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe small bites (SB) technique for closure of elective midline laparotomies (EMLs) and a prophylactic mesh (PM) in high-risk patients are suggested by the guidelines to prevent incisional hernias (IHs) and fascial dehiscence (FD). Our aim was to implement a protocol combining both the techniques and to analyze its outcomes.
methodsProspective data of all EMLs were collected for 2 years. Results were analyzed at 1 month and during follow-up. The incidence of HI and FD was compared by groups (M = Mesh vs. S = suture) and by subgroups depending on using SB.
resultsA lower number of FD appeared in the M group (OR 0.0692; 95% CI 0.008-0.56; P = 0.01) in 197 operations. After a mean follow-up of 29.23 months (N = 163; min. 6 months), with a lower frequency of IH in M group (OR 0.769; 95% CI 0.65-0.91; P < 0.0001). (33) The observed differences persisted after a propensity matching score: FD (OR 0.355; 95% CI 0.255-0.494; P < 0.0001) and IH (OR 0.394; 95% CI 0.24-0.61; P < 0.0001). On comparing suturing techniques by subgroups, both mesh subgroups had better outcomes. PM was the main factor related to the reduction of IH (HR 11.794; 95% CI 4.29-32.39; P < 0.0001).
conclusionFollowing the protocol using PM and SB showed a lower rate of FD and HI. A PM is safe and effective for the prevention of both HI and FD after MLE, regardless of the closure technique used.
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