Assessing the Role of Prophylactic Mesh Placement to Prevent Incisional Hernias After Laparotomy
DOI:
https://doi.org/10.63682/jns.v13i1.9276Keywords:
Incisional hernia, laparotomy, prophylactic mesh, surgical complications, hernia preventionAbstract
Background: To evaluate the effectiveness of prophylactic mesh placement in reducing the incidence of incisional hernia following laparotomy.
Methods: A prospective comparative study was conducted from January 2023 to January 2024, including 67 patients undergoing laparotomy. Participants were allocated into two groups: those receiving prophylactic mesh reinforcement (n = 34) and those with conventional suture closure (n = 33). Demographic, clinical, surgical, and postoperative variables were recorded. Patients were followed for one year to monitor wound complications and development of incisional hernia.
Results: The incidence of incisional hernia was significantly lower in the mesh group (5.9%) compared to the non-mesh group (27.3%, p = 0.02). Postoperative complications such as surgical site infection, seroma, and wound dehiscence were slightly higher in the non-mesh group, though differences were not statistically significant. Hospital stay was comparable between groups.
Conclusion: Prophylactic mesh placement is a safe and effective strategy to prevent incisional hernia after laparotomy. Its use should be considered in patients with identifiable risk factors such as obesity, diabetes, and emergency surgery.
Downloads
References
Tansawet, A., et al., Mesh position for hernia prophylaxis after midline laparotomy: a systematic review and network meta-analysis of randomized clinical trials. 2020. 83: p. 144-151.
Aiolfi, A., et al., Prophylactic mesh reinforcement for midline incisional hernia prevention: systematic review and updated meta-analysis of randomized controlled trials. 2023. 27(2): p. 213-224.
Jairam, A.P., et al., Prevention of incisional hernia after midline laparotomy with prophylactic mesh reinforcement: a meta-analysis and trial sequential analysis. 2020. 4(3): p. 357-368.
Burns, F.A., et al., Is there a role for prophylactic mesh in abdominal wall closure after emergency laparotomy? A systematic review and meta-analysis. 2020. 24(3): p. 441-447.
Aiolfi, A., et al., What is the ideal mesh location for incisional hernia prevention during elective laparotomy? A network meta-analysis of randomized trials. 2023. 109(5): p. 1373-1381.
Pereira-Rodríguez, J.A., et al., Implementing a protocol to prevent incisional hernia in high-risk patients: a mesh is a powerful tool. 2022. 26(2): p. 457-466.
Brandsma, H.-T., et al., Prophylactic mesh placement during formation of an end-colostomy: long-term randomized controlled trial on effectiveness and safety. 2023, LWW.
Peltrini, R., et al., Prevention of incisional hernia at the site of stoma closure with different reinforcing mesh types: a systematic review and meta-analysis. 2021. 25(3): p. 639-648.
Depuydt, M., et al., Prophylactic mesh after midline laparotomy: evidence is out there, but why do surgeons hesitate? 2021. 45(5): p. 1349-1361.
Lima, H.V., et al., Prevention of fascial dehiscence with onlay prophylactic mesh in emergency laparotomy: a randomized clinical trial. 2020. 230(1): p. 76-87.
Hassan, M.A., et al., Prophylactic onlay mesh repair (POMR) versus primary suture repair (PSR) for prevention of incisional hernia (IH) after abdominal wall surgery: a systematic review and meta-analysis. 2021. 45(10): p. 3080-3091.
Sahebally, S.M., et al., Prophylactic mesh placement at index permanent end colostomy creation to prevent parastomal hernia—an updated meta-analysis. 2021. 36(9): p. 2007-2016.
Ulutas, M., et al., Does onlay mesh placement in emergency laparotomy prevent incisional hernia? A prospective randomized double-blind study. 2023. 27(4): p. 883-893.
McKechnie, T., et al., Prophylactic mesh for prevention of parastomal hernia following end colostomy: an updated systematic review and meta-analysis of randomized controlled trials. 2022. 26(2): p. 486-502.
Frassini, S., et al., Prophylactic mesh augmentation after laparotomy for elective and emergency surgery: meta-analysis. 2023. 7(4): p. zrad060.
Olavarria, O.A., et al., Prophylactic mesh reinforcement for prevention of midline incisional hernias: a publication bias adjusted meta-analysis. 2023. 277(1): p. e162-e169.
DeAngelo, N. and A.J.J.S.C. Perez, Hernia Prevention: The Role of Technique and Prophylactic Mesh to Prevent Incisional Hernias. 2023. 103(5): p. 847-857.
Bravo-Salva, A., et al., Incidence of incisional hernia after emergency subcostal unilateral laparotomy: does augmentation prophylaxis play a role? 2020. 44(3): p. 741-748.
Frigault, J., et al., Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies. 2022. 26(2): p. 495-506.
Pizza, F., et al., Prophylactic sublay non-absorbable mesh positioning following midline laparotomy in a clean-contaminated field: randomized clinical trial (PROMETHEUS). 2021. 108(6): p. 638-643.
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.