title: 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.
  
  
  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.
  
  
  CONCLUSIONS
  Fitting a prophylactic supra-aponeurotic mesh prevents IH independently of other factors.
authors.affiliation: General and Digestive Surgery Service, Parc Taulí University Hospital, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain, dra5028@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Caro-Tarrago
authors.forename: C
authors.initials: C
authors.lastname: Olona Casas
authors.forename: A
authors.initials: A
authors.lastname: Jimenez Salido
authors.forename: E
authors.initials: E
authors.lastname: Duque Guilera
authors.forename: F
authors.initials: F
authors.lastname: Moreno Fernandez
authors.forename: V
authors.initials: V
authors.lastname: Vicente Guillen
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation*; D000368:Aged; D017558:Elective Surgical Procedures; D005260:Female; D006555:Hernia, Ventral / Q000517:prevention & control*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011126:Polypropylenes; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D049291:Seroma / Q000209:etiology; D013526:Surgical Mesh / Q000009:adverse effects
chemical_list: D011126:Polypropylenes