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Prophylactic mesh placement in emergency midline laparotomy for intestinal perforation peritonitis: An appeal for

Vivek Vijay Kumar1, Amrendra Verma1, Dileep Singh Thakur1

  • 1Department of Surgery, 534313NSCB Government Medical College, Jabalpur, India.

Tropical Doctor
|June 24, 2022
PubMed

Insights

Prophylactic mesh placement during emergency midline laparotomy for intestinal perforation increases wound dehiscence and mesh explantation. Routine use of prophylactic mesh in these cases is not recommended due to adverse outcomes.

Area of Science:

  • Abdominal Surgery
  • Surgical Materials
  • Hernia Repair

Background:

  • Incisional hernia prevention often involves prophylactic mesh placement after laparotomy.
  • Limited data exists on prophylactic mesh placement specifically for emergency midline laparotomy (EML) due to intestinal perforation.

Purpose of the Study:

  • To evaluate the efficacy and safety of prophylactic mesh placement (PMP) in patients undergoing EML for intestinal perforation.

Main Methods:

  • A comparative study involving 15 patients with non-absorbable PMP (Group A) and 20 patients with conventional closure (Group B) during EML for intestinal perforation.
  • Outcomes assessed included wound dehiscence, surgical site infection (SSI), and incisional hernia rates.

Main Results:

  • Group A showed a significantly higher incidence of wound dehiscence compared to Group B.
  • Surgical site infection and incisional hernia rates were similar between the two groups.
  • Half of the patients in Group A required mesh explantation.

Conclusions:

  • Prophylactic non-absorbable mesh placement during EML for intestinal perforation is associated with increased wound dehiscence and mesh explantation rates.
  • The routine use of prophylactic mesh in this specific patient population is not justified based on current findings.
Keywords:
emergency midline laparotomyintestinal perforationprophylactic mesh

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