Evidence map›Paper›PMID 39549074›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2024

Prophylactic mesh versus primary closure in emergency and elective surgeries: a systematic review and meta-analysis of randomized clinical trials.

Ana Paula Valério-Alves, Caio Leonardo Dos Santos Saggin, João Marcos Escórcio de Aguiar Portela, Patricia Viana, Gabriela Branquinho Guerra, Camila Mariana de Paiva Reis, Rafael Morriello

Erratum issuedAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Ana Paula Valério-AlvesDepartment of Medicine, Barao de Maua University Center, Ribeirao Preto, Sao Paulo, Brazil.ORCID 0000-0003-0962-7208
Caio Leonardo Dos Santos SagginDepartment of General Surgery, Federal University of Mato Grosso, Cuiaba, Mato Grosso, Brazil.
João Marcos Escórcio de Aguiar PortelaDepartment of General Surgery, Santa Maria Hospital, Teresina, Piaui, Brazil.
Patricia VianaDepartment of Medicine, Extremo Sul Catarinense University, Criciuma, Santa Catarina, Brazil.
Gabriela Branquinho GuerraDepartment of Medicine, Escola Superior de Ciências da Saúde, Brasilia, Distrito Federal, Brazil.
Camila Mariana de Paiva ReisDepartment of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
Rafael MorrielloDepartment of General Surgery, Federal Servants Hospital of Rio de Janeiro, Sacadura Cabral Street, 178, Rio de Janeiro, RJ, 20221-161, Brazil. rafaelmorriello@gmail.com.ORCID 0009-0000-9722-8519

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIncisional hernia is one of the most common post-operative complications. Previous studies showed that prophylactic mesh placement in laparotomy closure is safe and reduces the incidence of incisional hernia. We aimed to perform a meta-analysis comparing post-operative complications after the use of prophylactic permanent mesh placement versus primary closure in patients undergoing elective or emergency laparotomies.

methodsA systematic review of Cochrane Central Register of Controlled Trials, Embase and PubMed was performed in April 2024. Only randomized clinical trials were included. 1,234 studies were imported for screening. 280 were duplicated reports, 923 were excluded for irrelevancy and 16 were excluded after full-text review. Data were extracted in accordance with PRISMA guidelines and pooled by a random-effects model. The primary outcome was incidence of incisional hernia. Secondary outcomes included post-operative complications and period of hospitalization.

resultsFifteen studies and 2,108 patients were included. Incisional hernia incidence was different between groups (risk ratio [RR] 0.30; 95% CI 0.21-0.43; p < 0.00001; I²=39%). This finding was confirmed in a subgroup analysis of elective (RR 0.29; 95% CI 0.18-0.46; p < 0.00001; I²=48%) versus emergency laparotomies (RR 0.28; 95% CI 0.19-0.43; p = 0.0001; I²=0%). There was no significant difference in incisional hernia incidence by locals of mesh placement. Secondary outcomes had shown no statistically significant difference between groups, except for seroma wherein primary closure had lower events (RR 1.80; CI 95% 1.21-2.68; p = 0.38; I²=7%).

conclusionIn patients undergoing laparotomy, prophylactic permanent mesh placement is associated with a significant reduction on incidence of incisional hernia as compared to primary closure.

Indexed as

Abdominal Wound Closure TechniquesElective Surgical ProceduresIncisional HerniaSurgical MeshHumansLaparotomyRandomized Controlled Trials as TopicIncisional herniaLaparotomyPostoperative complicationsSurgical mesh

Identifiers

PMID39549074

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.