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01-12-2018 | Original Article

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

Authors: 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

Published in: Hernia | Issue 6/2018

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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Title: Long-term outcomes after prophylactic use of onlay mesh in midline laparotomy
Authors: 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
Publication date: 01-12-2018
Publisher: Springer Paris
Published in: Hernia / Issue 6/2018
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-018-1833-x

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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