Meta-analysis of primary mesh augmentation as prophylactic measure to prevent incisional hernia


Timmermans L., De Goede B., EKER H. H., Van Kempen B. J., Jeekel J., Lange J. F.

Digestive Surgery, cilt.30, sa.4-6, ss.401-409, 2014 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 30 Sayı: 4-6
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1159/000355956
  • Dergi Adı: Digestive Surgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.401-409
  • Anahtar Kelimeler: Incisional hernia, Primary mesh augmentation, Abdominal wall closure, Primary suture
  • Sağlık Bilimleri Üniversitesi Adresli: Hayır

Özet

Background: Incisional hernia (IH) remains one of the most frequent postoperative complications after abdominal surgery. As a consequence, primary mesh augmentation (PMA), a technique to strengthen the abdominal wall, has been gaining popularity. This meta-analysis was conducted to evaluate the prophylactic effect of PMA on the incidence of IH compared to primary suture (PS). Methods: A meta-analysis was conducted according to the PRISMA guidelines. Randomized controlled trials (RCTs) comparing PMA and PS for closing the abdominal wall after surgery were included. Results: Out of 576 papers, 5 RCTs were selected comprising 346 patients. IH occurred significantly less in the PMA group (RR 0.25, 95% CI 0.12-0.52, I20%; p < 0.001). No difference could be observed with regard to wound infection (RR 0.86, 95% CI 0.39-1.91, I2 0%; p = 0.71) or seroma (RR 1.22, 95% CI 0.64-2.33, I2 0%; p = 0.55). A trend was observed for chronic pain in favor of the PS group (RR 5.95, 95% CI 0.74-48.03, I20%; p = 0.09). Conclusion: The use of PMA for abdominal wall closure is associated with significantly lower incidence of IH compared to PS. © 2013 S. Karger AG, Basel.