Valoració de l'eficàcia d'una malla protèsica en la prevenció d'hèrnia incisional en pacients que precisen una laparotomia

Objective: to evaluate the prevention of incisional hernia during the postoperative period of a midline laparotomy during elective surgery. Material and 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) were given a standard abdominal wall closure and were not fitted with the mesh. Results: In group A 2/80 incisional hernias were diagnosed, whereas in group B the number was 30/80. The Kaplan-Meier survival curves show that the likelihood of incisional hernia at 12 months is 1.5% in group A compared to 35.9% in group B (p<0.0001), which means that the differences are statistically significant. The risk factotrs for incisional hernia are age>75 years old, BMI>30 and albumine <3g/dL. Conclusion: fitting a prophylactic supra-aponeurotic mesh prevents incisional hernia independently of other factors.