ArticleHernia : the journal of hernias and abdominal wall surgery2025
Outcomes of abdominal wall closure with fascial bridging using a polyglactin 910 (Vicryl) Mesh following non-trauma laparotomy: a multi-center study.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Pressure-induced posterior gastric perforation in a patient with severe gastroparesis and prior Nissen fundoplication.Journal of surgical case reports · 2026Article
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Abstract
introductionComplete primary fascial closure following midline laparotomy is occasionally unachievable, necessitating abdominal wall closure via fascial bridging with polyglactin 910 (Vicryl) mesh. Despite its frequent use, literature on the outcomes of Vicryl mesh for fascial bridging remains sparse and controversial, with some studies indicating potential associations with enterocutaneous fistulas and bowel obstruction. This study evaluates the outcomes of fascial bridging utilizing Vicryl mesh for non-trauma laparotomies.
methodsWe conducted a retrospective analysis of adult patients who underwent abdominal wall closure using Vicryl mesh at Cleveland Clinic centers from January 2018 to April 2023. Data were extracted from the Epic System, focusing on outcomes including fistula formation, the need for interventions for small bowel obstruction, and overall wound and postoperative morbidity, with a minimum follow-up of six months.
resultsAmong the 124,536 patients who underwent non-trauma laparotomies, 202 (0.17%) met the inclusion criteria, with a median follow-up of 47 months (SD ± 18.9 months). Postoperative outcomes following abdominal wall closure with Vicryl mesh included a 48.5% rate of surgical site infections, a 27.2% incidence of skin dehiscence, a 9.9% occurrence of soft tissue necrosis, and 2% experienced bowel evisceration secondary to mesh detachment. Enterocutaneous fistulas developed in 8.4% of patients, with no interventions for small bowel obstruction required within the first six months postoperatively. These complication rates are comparable to other abdominal closure techniques in similarly complex cases.
conclusionsFascial bridging with Vicryl mesh is a safe method for abdominal wall closure, with enterocutaneous fistula and small bowel obstruction rates comparable to those seen with other techniques. Nevertheless, primary closure of the linea alba should be prioritized, with mesh implantation minimized whenever feasible.
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