Payne R, et al. - An updated meta-analysis was performed to better understand the evidence regarding prevention of an incisional hernia (IH) using prophylactic mesh. Findings revealed a reduction in the occurrence of IH after a laparotomy when a prophylactic mesh was used versus a suture repair. A high risk of IH was observed among the majority of patients included in the studies. Sufficient evidence supporting the use of a prophylactic mesh during laparotomy in high-risk patients was gained.

Methods

• Authors searched PubMed, clinictrials.gov.uk, and the Cochrane database for randomised controlled trials comparing closure of the abdomen after laparotomy using a prophylactic mesh with suture closure.
• They then performed a meta-analysis.
• The occurrence of IH was primarily assessed.

Results

• Authors identified eight studies for inclusion in the meta-analysis with a total of 727 patients.
• A significant reduction in the occurrence of IH was evident in the mesh group vs. the suture repair group, OR 0.14 (95% CI 0.07-0.27).
• Findings revealed a marked increase in the number of seromas in the mesh group vs. the suture repair group, OR 1.73 (95% CI 1.04-2.87).
• In addition, they observed a significant increase in operative time in the mesh group vs. the suture repair group SMD 0.24 (95% CI 0.00-0.48).