{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:04:27Z","timestamp":1790611467089,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Incisional hernias have an impact on patients\u2019 quality of life and on health care finances. Because of high recurrence rates despite mesh repair, the prevention of incisional hernias with prophylactic mesh reinforcement is currently a topic of interest. But only 15% of surgeons are implementing it, mainly because of fear for mesh complications and disbelief in the benefits. The goal of this systematic review is to evaluate the effectiveness and safety of prophylactic mesh in adult patients after midline laparotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An extensive literature search was performed in PubMed, Embase and CENTRAL until 9\/5\/2020 for RCTs and cohort studies regarding mesh reinforcement versus primary suture closure of a midline laparotomy. The quality of the articles was analyzed using the Scottish Intercollegiate Guidelines Network checklists. Revman 5 was used to perform a meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three articles were found with a total of 1633 patients in the mesh reinforcement group and 1533\u00a0in the primary suture group. An odds ratio for incisional hernia incidence of 0.37 (95% CI\u2009=\u2009[0.30, 0.46], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) with RCTs and of 0.15 (95% CI\u2009=\u2009[0.09,0.25], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) in cohort studies was calculated. Seroma rate shows a significant odds ratio of 2.18 (95% CI\u2009=\u2009[1.45, 3.29], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) in favor of primary suture. No increase was found regarding other complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The evidence for the use of prophylactic mesh reinforcement is overwhelming with a significant reduction in incisional hernia rate, but implementation in daily clinical practice remains limited. Instead of putting patients at risk for incisional hernia formation and subsequent complications, surgeons should question their arguments why not to use mesh reinforcement, specifically in high\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05898-0","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T21:22:57Z","timestamp":1612905777000},"page":"1349-1361","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Prophylactic Mesh After Midline Laparotomy: Evidence is out There, but why do Surgeons Hesitate?"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3553-5091","authenticated-orcid":false,"given":"Martijn","family":"Depuydt","sequence":"first","affiliation":[{"name":"Department of General and HPB Surgery and Liver Transplantation Ghent University Hospital Corneel Heymanslaan 10 9000 Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Allaeys","sequence":"additional","affiliation":[{"name":"Department of General and HPB Surgery and Liver Transplantation Ghent University Hospital Corneel Heymanslaan 10 9000 Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Abreu","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Department of General and HPB Surgery and Liver Transplantation Ghent University Hospital Corneel Heymanslaan 10 9000 Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aude","family":"Vanlander","sequence":"additional","affiliation":[{"name":"Department of General and HPB Surgery and Liver Transplantation Ghent University Hospital Corneel Heymanslaan 10 9000 Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Berrevoet","sequence":"additional","affiliation":[{"name":"Department of General and HPB Surgery and Liver Transplantation Ghent University Hospital Corneel Heymanslaan 10 9000 Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(03)00129-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.2002.02258.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-013-1119-2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200301000-00018"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-017-5936-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-13-48"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31332-6"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000355956"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-014-1262-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000141193.08524.e7"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.08.357"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-019-01894-z"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.06.022"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103252\u20109"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_17_1","unstructured":"Methodology Checklist 2: Controlled Trials. [document on the Internet]. (2015) [updated 2015 Sept 7]. Available from:http:\/\/www.sign.ac.uk\/methodology\/checklists.html"},{"key":"e_1_2_8_18_1","unstructured":"Methodology Checklist 3: Cohort studies. [document on the Internet].Scottish Intercollegiate Guidelines Network; (2015) [updated 2015 Sept 7]. Available from:http:\/\/www.sign.ac.uk\/methodology\/checklists.html"},{"key":"e_1_2_8_19_1","unstructured":"Methodology Checklist 6: Economic Evaluations. [document on the Internet]. (2015) [updated 2015 Sept 7]. Available from:http:\/\/www.sign.ac.uk\/methodology\/checklists.html"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-019-01761-6"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900420"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-014-1342-5"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60459-7"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7137"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-019-01891-2"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001369"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11081"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-011-0486-y"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20104363\u20102"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31332-6"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.4221"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2018.00008"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-014-1342-5"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481808400129"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001116"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-003-0124-2"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-009-0484-3"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481708300928"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002184"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.02.030"},{"key":"e_1_2_8_41_1","unstructured":"Organisation WH.Table: Threshold values for intervention cost\u2010effectiveness by Region2005 24\/10\/2016 24\/10\/2016]"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010019\u201004964\u20106"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.50261"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2016.09.055"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00104-016-0229-7"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.09.036"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-017-1653-4"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.02.020"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.5114\/ait.2019.87475"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-013-0915-1"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010014\u20102510\u20106"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-009-0484-3"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-019-02025-4"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5512"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.04.035"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20102019\u20104"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010011\u20101131\u20106"},{"key":"e_1_2_8_58_1","first-page":"876","article-title":"Absorbable mesh placement to prevent incisional hernias after donor hepatectomy","volume":"19","author":"Von Ahrens D","year":"2019","journal-title":"Am J Transplant"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05898-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-020-05898-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05898-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-020-05898-0","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T16:50:07Z","timestamp":1703350207000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-020-05898-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,8]]},"references-count":57,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1007\/s00268-020-05898-0"],"URL":"https:\/\/doi.org\/10.1007\/s00268-020-05898-0","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,8]]},"assertion":[{"value":"21 November 2020","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}