Evidence map›Paper›PMID 40646274›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2025

Prophylactic mesh reinforcement in elective abdominal surgeries: a systematic review, meta-analysis, and GRADE evidence assessment.

Ahmed W Abbas, Mohamed F Abo-Elsoad, Mahmoud Diaa Hindawi, Mohamed Abo Zeid, Abd-Elfattah Kalmoush, Menna M Aboelkier, Mohamed A Aldemerdash, Rashad G Mohamed, Hosam Elghadban

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis 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 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. Review
  4. Review
  5. 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

9 authors.

Ahmed W AbbasFaculty of Medicine, Mansoura University, Mansoura, Egypt. dr.ahmedw1267hh@gmail.com.ORCID 0000-0003-3451-8580
Mohamed F Abo-ElsoadFaculty of Medicine, Mansoura University, Mansoura, Egypt.ORCID 0009-0004-7237-2206
Mahmoud Diaa HindawiFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID 0009-0001-3085-6665
Mohamed Abo ZeidFaculty of Medicine, Tanta University, Tanta, Egypt.ORCID 0009-0007-8165-9470
Abd-Elfattah KalmoushFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID 0000-0001-6927-223X
Menna M AboelkierMaster program, Faculty of Science, Cairo University, Cairo, Egypt.ORCID 0000-0002-7648-2224
Mohamed A AldemerdashFaculty of Medicine, Sohag University, Sohag Al Gadida City, Egypt.ORCID 0009-0006-0939-7923
Rashad G MohamedMansoura Manchester Program for Medical Education, Faculty of Medicine, Mansoura University, Mansoura, Egypt.ORCID 0009-0004-2962-0075
Hosam ElghadbanFaculty of Medicine, Mansoura University, Mansoura, Egypt.ORCID 0000-0003-3076-301X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElective laparotomies account for a larger fraction of laparotomy procedures performed worldwide. Although surgical techniques continue to advance, the incidence of incisional hernia (IH) and other post-operative complications remain challenging to surgeons. This study aimed to evaluate the significance of using prophylactic mesh reinforcement during elective laparotomy.

methodsA comprehensive search was conducted in PubMed, Scopus, and Web of Science to identify studies that included adults undergoing elective abdominal surgery and compared prophylactic mesh reinforcement of the abdominal wall using any type of mesh in any anatomical position to standard fascial closure with sutures alone, without mesh. The analysis aimed to assess the impact of mesh reinforcement on the incidence of IH at all possible timepoints, in addition to secondary outcomes based on mesh technique, such as wound infections, dehiscence, seroma, re-operation for IH, and prolonged hospital stay. Data analysis was performed using the R programming language.

resultsFifteen RCTs, including 2,233 patients with follow-up durations ranging from 1.5 to 5 years, were analyzed. Prophylactic mesh reinforcement significantly reduced the incidence of IH following elective gastrointestinal surgeries at 12 months (risk ratio [RR] = 0.35, 95% confidence interval [CI] [0.14; 0.86], p = 0.02), 24 months (RR = 0.28, 95% CI [0.11; 0.68], p < 0.01), 36 months (RR = 0.62, 95% CI [0.36; 1.06], p = 0.08), and 48 months (RR = 0.35, 95% CI [0.11; 1.17], p = 0.09). Similarly, mesh significantly reduced IH rates following open abdominal aortic aneurysm repair at 12 months (RR = 0.13, 95% CI [0.04; 0.41], p < 0.01), 24 months (RR = 0.31, 95% CI [0.21; 0.45], p < 0.01), and 36 months (RR = 0.23, 95% CI [0.10; 0.54], p < 0.01).

conclusionsProphylactic mesh reinforcement during elective abdominal laparotomy significantly reduced the incidence of IH and the need for reoperation. However, it is associated with an increased risk of seroma formation and, to a lesser extent, wound infection, particularly with the Sublay technique.

Indexed as

Elective Surgical ProceduresIncisional HerniaLaparotomyPostoperative ComplicationsSurgical MeshAbdominal WallHumansAbdominal wall closureElective laparotomyIncisional herniaMESH

Identifiers

PMID40646274
PMCPMC12254175

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.