Here are five takeaways:
1. Sherry Wren, MD, professor surgery at the Stanford University School of Medicine and director of clinical surgery at VA Palo Alto Health Care System (Calif.,) presented an overview of recent published trials that strongly favor mesh reinforcement at the 2015 American College of Surgeons Clinical Congress.
2. One of the most robust recent studies to examine mesh placement for the prevention of tracer site incisional hernia trial was published last spring in Annals of Surgery. The study showed a substantial drop in incisional hernia rates in the year after surgery when mesh was used to reinforce the closure. Patients who received a mesh had a 11.3 percent hernia rate, while those without had a 31.5 percent hernia rate.
3. Miguel ángel García-Ureña, PhD, MD, lead author of the study and chair and professor of surgery at Francisco de Vitoria University in Madrid, said he changed his practice as a result of the study.
4. It was also found in the study that the use of mesh was cost-effective due to the number needed to treat; one incisional hernia was prevented for every five prophylactic meshes that were used.
5. Dr. Wren said despite the evidence, the reason the use of mesh as a prophylaxis against incisional hernia is rarely performed is largely due to the fear of infection, complication or litigation. There’s also a common belief among surgeons against permanent prosthetics in contaminated cases.
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