Use of prophylactic mesh for prevention of incisional hernia following midline laparotomy

Abstract

Background Incisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh placement may significantly reduce IH but is not widely used. This study aimed to assess the safety and efficacy of prophylactic mesh placement in preventing IH development after midline laparotomy. Patients and methods This was a prospective observational study on 83 patients undergoing midline laparotomy admitted to our hospital during the period from August 2017 to January 2020. The patients were randomized into two groups: the suture group (SG), with nonabsorbable running sutures, and the prophylactic mesh group, with fascial closure as in the SG but reinforced with onlay polypropylene mesh. Results There was no significant difference observed in mean age, sex, mean BMI, mean hospital stay, and mean follow-up period between both the groups. A statistically significant reduction in IH incidence was demonstrated in the mesh group, with one (2.56%) case, than in the SG, with 11 (25.0%) cases. Surgical site occurrence had higher incidences in the mesh group (25.64%) than in the SG (6.82%). Conclusion Reinforcement of the midline closure by onlay mesh has been proved to be an effective and safe method for avoidance of IH in high-risk patients in both elective and emergency operations during the follow-up period.