Efficacy and safety of mesh closure in preventing wound failure following emergency laparotomy: a systematic review and meta-analysis.
Author
Albendary, MohamedMOHAMEDAHMED, Ali Yasen Y.
Alamin, Amin
Rout, Shantanu
George, Anil
Zaman, Shafquat
Affiliation
Altnagelvin Area Hospital; Sandwell and West Birmingham NHS TrustPublication date
2022-01-12Subject
Surgery
Metadata
Show full item recordAbstract
Aims: To evaluate comparative outcomes of emergency laparotomy closure with and without prophylactic mesh. Methods: A systematic review was performed via literature databases: PubMed, Cochrane Library, Science Direct, and Google Scholar. Studies were examined for eligibility and included if they compared prophylactic mesh closure to the conventional laparotomy closure following emergency abdominal surgery. Both acute wound failure and incisional hernia (IH) occurence were our primary outcomes. Secondary outcomes included surgical site infection (SSI), seroma/hematoma formation, Clavien-Dindo complications (score ≥ 3), total operative time, and length of hospital stay (LOS). Results: Two randomised controlled trials (RCTs) and four comparative studies with a total of 817 patients met the inclusion criteria. Overall acute wound failure and incisional hernia rate was significantly lower in the mesh group compared to non-mesh group (odd ratio (OR) 0.23, p = 0.002) and (OR 0.21, p = 0.00001), respectively. There was no significant difference between the two groups regarding the following outcomes: total operative time (mean difference (MD) 21.44, p = 0.15), SSI (OR 1.47, p = 0.06), seroma/haematoma formation (OR 2.74, p = 0.07), grade ≥ 3 Clavien-Dindo complications (OR 2.39, p = 0.28), and LOS (MD 0.26, p = 0.84). Conclusion: The current evidence for the use of prophylactic mesh in emergency laparotomy is diverse and obscure. Although the data trends towards a reduction in the incidence of IH, a reliable conclusion requires further high-quality RCTs to fully assess the efficacy and safety of mesh use in an emergency setting.Citation
Albendary, M., Mohamedahmed, A. Y. Y., Alamin, A., Rout, S., George, A., & Zaman, S. (2022). Efficacy and safety of mesh closure in preventing wound failure following emergency laparotomy: a systematic review and meta-analysis. Langenbeck's archives of surgery, 407(4), 1333–1344. https://doi.org/10.1007/s00423-021-02421-4Type
ArticlePMID
35020082Journal
Langenbeck's Archives of SurgeryPublisher
Springerae974a485f413a2113503eed53cd6c53
10.1007/s00423-021-02421-4