The invite study: incisional hernia prevention: prophylactic mesh from the patient's perspective

Area of Science:

• Surgical Innovation
• Patient Outcomes
• Medical Device Perception

Background:

• Mesh prophylaxis significantly reduces incisional hernia rates in high-risk surgical patients.
• Despite evidence, mesh prophylaxis adoption is low in the US and UK, potentially due to negative public perception of surgical mesh.
• Understanding patient perspectives is crucial for increasing mesh prophylaxis utilization.

Purpose of the Study:

• To evaluate patient acceptability of mesh prophylaxis for abdominal wall closure.
• To identify factors influencing patient acceptance of surgical mesh.
• To inform the development of patient-centered resources supporting mesh prophylaxis.

Main Methods:

• A convergent mixed-methods study involving 332 patients undergoing abdominal surgery.
• Quantitative data collected via questionnaires on mesh knowledge and opinions (n=120 responses).
• Qualitative data gathered through semi-structured interviews with a subset of patients (n=12) and thematic analysis.

Main Results:

• Over 60% of patients had heard of surgical mesh, with about half holding negative associations, often media-driven.
• Despite 50% having pre-existing concerns, 91% found mesh prophylaxis acceptable.
• Qualitative analysis revealed themes of "Knowledge of mesh," "Acceptability of mesh," and "Shared decision-making."

Conclusions:

• Mesh prophylaxis is generally acceptable to patients, even with prior negative perceptions.
• Patient information delivery and shared decision-making significantly impact mesh acceptability.
• Further research into surgeon barriers is needed for wider implementation of prophylactic mesh.