title: Randomized clinical trial of postoperative hernia prophylaxis in open bariatric surgery.
abstract: BACKGROUND
  Postoperative hernia following bariatric procedures is more common than in other groups of surgical patients, and remains a serious problem. Gastric bypass is the most often performed bariatric procedure and, despite the increasing popularity of a laparoscopic approach, many morbidly obese patients are still offered open procedures. The aim of this study was to assess the effects of prophylactic polypropylene mesh in morbidly obese patients undergoing gastric by-pass surgery.
  
  
  METHODS
  The study randomized 74 patients undergoing open Roux-en-Y gastric bypass into two groups: wound closure with (n = 36) or without (n = 38) a polypropylene mesh. Mean(s.d.) body mass and body mass index in the mesh group were 137.3(24.5) kg and 46.2(7.1) kg/m(2) and in the non-mesh group were 139.0(24.9) kg and 46.8(7.6) kg/m(2) respectively. In the non-mesh group, the wound was closed with a polypropylene suture. Patients in the mesh group had in addition a polypropylene mesh inserted in a sublay manner.
  
  
  RESULTS
  Patients were followed up for at least 6 (range 6-38) months. Hernia developed in eight patients in the non-mesh group but in none in the mesh group. The duration of hospital stay was similar in both groups: mean(s.d.) 8.4(3.2) and 10.3(5.9) days (P = 0.092). There were no serious complications in either group.
  
  
  CONCLUSIONS
  The use of a mesh prevented hernia development and did not lengthen hospital stay.
authors.affiliation: Department of General and Transplant Surgery, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland. januszst@toya.net.pl
authors.forename: J M
authors.initials: JM
authors.lastname: Strzelczyk
authors.forename: D
authors.initials: D
authors.lastname: Szymański
authors.forename: M E
authors.initials: ME
authors.lastname: Nowicki
authors.forename: W
authors.initials: W
authors.lastname: Wilczyński
authors.forename: T
authors.initials: T
authors.lastname: Gaszynski
authors.forename: L
authors.initials: L
authors.lastname: Czupryniak
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006555:Hernia, Ventral / Q000517:prevention & control*; D006801:Humans; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D011126:Polypropylenes; D011183:Postoperative Complications / Q000517:prevention & control*; D013526:Surgical Mesh
chemical_list: D011126:Polypropylenes