Prophylactic mesh versus primary closure in emergency and elective surgeries: a systematic review and meta-analysis of randomized clinical trials

Purpose Incisional hernia is one of the most common post-operative complications. Previous studies showed that prophylactic mesh placement in laparotomy closure is safe and reduces the incidence of incisional hernia. We aimed to perform a meta-analysis comparing post-operative complications after th...

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Published in:Hernia : the journal of hernias and abdominal wall surgery 2024-11, Vol.29 (1), p.14, Article 14
Main Authors: Valério-Alves, Ana Paula, Saggin, Caio Leonardo dos Santos, de Aguiar Portela, João Marcos Escórcio, Viana, Patricia, Guerra, Gabriela Branquinho, de Paiva Reis, Camila Mariana, Morriello, Rafael
Format: Article
Language:English
Subjects:
Abdominal Surgery
Abdominal Wound Closure Techniques - instrumentation
Clinical trials
Complications
Elective Surgical Procedures - adverse effects
Hernia
Hernias
Humans
Incisional Hernia - epidemiology
Incisional Hernia - etiology
Incisional Hernia - prevention & control
Laparotomy
Laparotomy - adverse effects
Medicine
Medicine & Public Health
Meta-analysis
Original Article
Patients
Postoperative
Randomized Controlled Trials as Topic
Statistical analysis
Surgical Mesh
Systematic review
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Summary:Purpose Incisional hernia is one of the most common post-operative complications. Previous studies showed that prophylactic mesh placement in laparotomy closure is safe and reduces the incidence of incisional hernia. We aimed to perform a meta-analysis comparing post-operative complications after the use of prophylactic permanent mesh placement versus primary closure in patients undergoing elective or emergency laparotomies. Methods A systematic review of Cochrane Central Register of Controlled Trials, Embase and PubMed was performed in April 2024. Only randomized clinical trials were included. 1,234 studies were imported for screening. 280 were duplicated reports, 923 were excluded for irrelevancy and 16 were excluded after full-text review. Data were extracted in accordance with PRISMA guidelines and pooled by a random-effects model. The primary outcome was incidence of incisional hernia. Secondary outcomes included post-operative complications and period of hospitalization. Results Fifteen studies and 2,108 patients were included. Incisional hernia incidence was different between groups (risk ratio [RR] 0.30; 95% CI 0.21–0.43; p  
ISSN:1248-9204
1265-4906
1248-9204
DOI:10.1007/s10029-024-03202-w