Prevention of incisional hernia in midline laparotomy with an onlay mesh: a randomized clinical trial.

ABSTRACT

OBJECTIVE: Our objective was to evaluate the prevention of incisional hernia (IH) during the postoperative period of a midline laparotomy during elective surgery. MATERIAL AND METHODS: A controlled, prospective, randomized, and blind study was carried out. The patients in group A (mesh) were fitted with a polypropylene mesh, to reinforce the standard abdominal wall closure. The patients in group B (non-mesh) underwent a standard abdominal wall closure and were not fitted with the mesh. RESULTS: In group A, 2/80 his were diagnosed, whereas in group B the number was 30/80. The Kaplan-Meier survival curves show that the likelihood of IH at 12 months is 1.5 % in group A compared with 35.9 % in group B (p < 0.0001), which means that the differences are statistically significant. CONCLUSION: Fitting a prophylactic supra-aponeurotic mesh prevents IH independently of other factors.