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Prophylactic mesh augmentation: Patient selection, techniques, and early outcomes
Irfan A Rhemtulla1, Jaclyn T Mauch1, Robyn B Broach1
1Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Background:
Incisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh augmentation (PMA) has emerged as a technique to reduce IH formation. We aim to report patient selection, techniques and early outcomes after PMA.
Methods:
Retrospective chart review identified descriptive characteristics, risk factors, operative technique, and early post-operative outcomes for PMA patients and matched non-PMA patients between January 1, 2016 and October 31, 2017.
Results:
18 consecutive PMA cases were performed (55.6% female, mean age 54.3 years and mean BMI = 29.5 kg/m2). 88.9% of patients had at least two high-risk features for IH. Zero PMA patients developed IH compared to 5.3% non-PMA patients (p = 0.314) (6-months mean follow-up). No difference in surgical site occurrences (SSO) were identified between the two groups.
Conclusions:
Early results are encouraging, demonstrating PMA is safe with equivocal SSO. Further studies are needed to assess if the reduction in IH formation is statistically significant with longer follow-up.
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