ArticleJournal of abdominal wall surgery : JAWS2026
Incisional hernia prevention in high-risk midline laparotomy using onlay PVDF mesh: multicenter prospective observational study.
Article in Journal of abdominal wall surgery : JAWS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Prophylactic mesh reinforcement reduces the risk of incisional hernia after midline laparotomy in high-risk patients, although concerns regarding complications and implementation limit its routine use. This multicentre prospective observational study evaluated long-term outcomes after onlay polyvinylidene fluoride (PVDF) mesh reinforcement in high-risk patients undergoing midline laparotomy in elective and emergency settings. Materials and methods: A prospective multicentre observational cohort study was conducted in tertiary and secondary hospitals within the Spanish National Health Service between July 2016 and June 2022. Adult patients undergoing midline laparotomy with more than one risk factor for incisional hernia were included. Abdominal wall closure was reinforced with an onlay PVDF mesh visible on MRI. The primary outcome was incisional hernia at 2 years. Secondary outcomes included mesh-related complications and factors associated with incisional hernia. Results: A total of 180 patients were analysed. Mean age was 64.6 years and mean BMI was 27.4 kg/m Conclusion: In this prospective multicentre observational study, prophylactic onlay PVDF mesh reinforcement in high-risk midline laparotomy, including emergency and contaminated procedures, was feasible and associated with a low incidence of incisional hernia and acceptable mesh-related morbidity. These findings are hypothesis-generating and warrant further evaluation in controlled studies.
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