Prevention of Incisional Hernia in Midline Laparotomy with an Onlay Mesh: A Randomized Clinical Trial

Caro, Aleidis; Casas, Carles Olona; Salido, Andrea Jiménez; Guilera, Enric Duque; Fernandez, F. Moreno; Guillén, Vicente

doi:10.1007/s00268-014-2510-6

Cited by 69 publications

(81 citation statements)

References 45 publications

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“…Prophylactic mesh augmentation is effective in the prevention of incisional hernias (RR 0.17: CI 0.08-0.37). An increased incidence of postoperative seroma is identified, but the majority of these are from the single study by Caro-Tarrago et al [106] where the mesh was placed in an onlay position, with a weight of 45.9 % on the cumulative Risk Ratio for seroma (RR = 1.71; 95 %CI: 1.06-2.76) (Fig. 2c).…”

Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

“…All other studies published used a polypropylene mesh, most often a small pore/heavy weight mesh: Prolene; Ethicon [110], Premilene; B. Braun [107], no name mentioned [105,108,109]. Only Caro-Tarrago et al [106] used a large pore/ light weight mesh: Biomesh Light P8; Cousin Biotech.…”

Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

“…One additional RCT published after the review by Timmermans et al [106] was identified. In this RCT, one hundred and sixty patients were included.…”

Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

“…Using Review Manager 5.2 software a new meta-analysis was performed. The data for this meta-analysis were extracted from the Timmermans et al metaanalysis and the additional RCT [104,106]. A meta-analysis on the outcomes of incisional hernia, seroma and SSI was performed.…”

Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

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European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

505

406

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Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

“…One additional RCT published after the review by Timmermans et al [106] was identified. In this RCT, one hundred and sixty patients were included.…”

Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

Section: Prophylactic Mesh Augmentationmentioning

confidence: 99%

See 2 more Smart Citations

European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

505

406

View full text Add to dashboard Cite

show abstract

“…Sin embargo, a pesar de ello, aún falta evidencia para determinar a quiénes y en qué espacio se debe de colocar la malla [13][14][15][16] .…”

Section: Introductionunclassified

Comparación de dos técnicas de sutura para cierre aponeurótico en laparotomía media en pacientes con alto riesgo de evisceración posquirúrgica

Hernández¹,

González²,

Kurek³

et al. 2017

Rev Hispanoam Hernia

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Introducción: La evisceración posquirúrgica es una complicación con origen multifactorial.Los estudios para prevenirla modifican la técnica de cierre. La técnica reinforced tensión line(RTL) se ha usado en el tratamiento de hernias incisionales.Material y métodos: Ensayo clínico en pacientes sometidos a laparotomía media. Se formarondos grupos: 1) control con cierre habitual, y 2) grupo experimental con la técnica RTL. Seevaluó la presencia de evisceración posquirúrgica.Resultados: Terminaron el estudio 89 pacientes. Se presentaron un total de 9 (20 %) y 2 (4.5 %)evisceraciones, con diferencia a favor de la técnica RTL con una p de 0.0273.Conclusiones: Se encontró que la técnica RTL reduce la incidencia de evisceración posquirúr-gica.

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Prevention of incisional hernia after midline laparotomy with prophylactic mesh reinforcement: a meta-analysis and trial sequential analysis

et al. 2020

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Background: Incisional hernia is a frequent complication after abdominal surgery. The aim of this study was to assess the efficacy of prophylactic mesh reinforcement (PMR) after midline laparotomy in reducing the incidence of incisional hernia.Methods: A meta-analysis was conducted following PRISMA guidelines. The primary outcome was the incidence of incisional hernia after follow-up of at least 12 months. Secondary outcomes were postoperative complications. Only RCTs were included. A random-effects model was used for the meta-analysis, and trial sequential analysis was conducted.Results: Twelve RCTs were included, comprising 1815 patients. The incidence of incisional hernia was significantly lower after PMR compared with sutured closure (risk ratio (RR) 0⋅35, 95 per cent c.i. 0⋅21 to 0⋅57; P < 0⋅001). Both onlay (RR 0⋅26, 0⋅11 to 0⋅67; P = 0⋅005) and retromuscular (RR 0⋅28, 0⋅10 to 0⋅82; P = 0⋅02) PMR led to a significant reduction in the rate of incisional hernia. The occurrence of seroma was higher in patients who had onlay PMR (RR 2⋅23, 1⋅10 to 4⋅52; P = 0⋅03). PMR did not result in an increased rate of surgical-site infection.Conclusion: PMR of a midline laparotomy using an onlay or retromuscular technique leads to a significant reduction in the rate of incisional hernia in high-risk patients. Individual risk factors should be taken into account to select patients who will benefit most.[Correction added on 19 February 2020, after first online publication: J. García Alamino has been amended to J. M. Garcia-Alamino]

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Prevention of Incisional Hernia in Midline Laparotomy with an Onlay Mesh: A Randomized Clinical Trial

Abstract: Fitting a prophylactic supra-aponeurotic mesh prevents IH independently of other factors.

Cited by 69 publications

References 45 publications

European Hernia Society guidelines on the closure of abdominal wall incisions

European Hernia Society guidelines on the closure of abdominal wall incisions

Comparación de dos técnicas de sutura para cierre aponeurótico en laparotomía media en pacientes con alto riesgo de evisceración posquirúrgica

Prevention of incisional hernia after midline laparotomy with prophylactic mesh reinforcement: a meta-analysis and trial sequential analysis

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