Primary closure of laparotomies with high risk of incisional hernia using prosthetic material: analysis of usefulness.
Incisional hernia continues to be a serious postoperative complication in abdominal surgery. We present a prospective randomised study to evaluate the usefulness of placement of a supra-aponeurotic polypropylene mesh in the primary closure of laparotomies with a high risk of incisional hernia. Closure of a vertical laparotomy in 100 patients was accomplished with continuous suture using non-reabsorbable material, with placement of a polypropylene mesh on the aponeurotic surface in 50 patients. Three years after surgery, five patients in the group without the mesh had suffered incisional hernia. No incisional hernia was detected in the group in which closure was made using the mesh (P=0.02). Use of prosthetic material (polypropylene mesh) in the primary closure of laparotomies with a high risk of incisional hernia is useful for reduction of the rate of incisional hernias.
Gutiérrez de la Peña
C
C
Department of Surgery, General Hospital, Jerez, Spain. carlos-gutierrez@telefonica.net
Medina Achirica
C
C
Domínguez-Adame
E
E
Medina Díez
J
J
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011322:Primary Prevention / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013526:Surgical Mesh; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology
D011126:Polypropylenes