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Erschienen in: Hernia 6/2018

04.10.2018 | Original Article

Long-term outcomes after prophylactic use of onlay mesh in midline laparotomy

verfasst von: C. San Miguel, D. Melero, E. Jiménez, P. López, Á. Robin, L. A. Blázquez, J. López-Monclús, E. González, C. Jiménez, M. Á. García-Ureña

Erschienen in: Hernia | Ausgabe 6/2018

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Abstract

Background

The prevalence of incisional hernias (IHs) is still high after midline laparotomy (ML). There is an increasing body of evidence that prophylactic mesh placement (PMP) can be safe and efficient in the short-term outcomes, but there still are some concerns about the potential long-term complications of these meshes. This study describes our long-term PMP experience.

Methods

Observational and prospective study including all patients undergoing the use of prophylactic onlay large-pore polypropylene meshes for the closure of ML since 2008 to 2014. Outcome measures included demographics, perioperative details, wound complications, recurrences, reoperations and chronic complications.

Results

A cohort of 172 patients was analysed: 75% elective surgery, 25% emergency cases. Mean age was 68 years with mean body mass index (BMI) of 28.6 kg/m2. Wound classification: 6.4% clean; 85% clean-contaminated; 1.2% contaminated and 8.1% dirty. Follow-up of patients was up to 8 years (mean: 5 ± 1.6). Two meshes were removed due to chronic infection in first six postoperative months. Of the 13 patients (9.02%) who developed IH, 5 of them have been reoperated for IH repair without any difficulty related to previous mesh. During follow-up, 8 patients have been reoperated for other reasons and the integrity of abdominal wall was also checked. After the comparative study, higher BMI and emergency surgery were still risk factors for IH despite PMP.

Conclusions

In our setting, the use of polypropylene prophylactic meshes in MLs is safe, efficient and durable.
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Metadaten
Titel
Long-term outcomes after prophylactic use of onlay mesh in midline laparotomy
verfasst von
C. San Miguel
D. Melero
E. Jiménez
P. López
Á. Robin
L. A. Blázquez
J. López-Monclús
E. González
C. Jiménez
M. Á. García-Ureña
Publikationsdatum
04.10.2018
Verlag
Springer Paris
Erschienen in
Hernia / Ausgabe 6/2018
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-018-1833-x

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