Prophylactic use of synthetic meshes in emergency laparotomy closure: a systematicreview and meta-analysis
DOI:
https://doi.org/10.69849/b519nc13Keywords:
Laparotomia., Telas sintéticas., Deiscência fascial., Hérnia incisional.Abstract
Background: Fascial dehiscence and incisional hernia are frequent complications following emergency and urgent laparotomies, being associated with increased morbidity, higher healthcare costs, and impaired quality of life. Although prophylactic synthetic mesh reinforcement is well established in elective surgery – particularly in high-risk patients – its role in non-elective settings remains controversial.
Objective: To evaluate the efficacy and safety of prophylactic synthetic mesh placement for abdominal wall closure after emergency and urgent laparotomy.
Methods: A systematic search was conducted in the PubMed and Scopus databases to identify randomized controlled trials comparing fascial closure with and without prophylactic synthetic mesh in emergency laparotomy. The primary outcome was fascial dehiscence. Secondary outcomes included incisional hernia, surgical site complications (seroma, hematoma, and surgical site infection), and operative time. Subgroup analyses were performed according to mesh position and degree of surgical field contamination.
Results: Four randomized controlled trials comprising a total of 488 patients were included. Prophylactic mesh placement significantly reduced the risk of fascial dehiscence (RR 0.24) and incisional hernia (RR 0.33), without increasing the incidence of surgical site complications. Operative time was longer in the mesh group, particularly when the retromuscular technique was used. The beneficial effects of mesh reinforcement were consistent across subgroup analyses according to mesh position and wound contamination status.
Conclusion: Prophylactic synthetic mesh reinforcement in emergency laparotomy closure is an effective and safe strategy, significantly reducing fascial dehiscence and incisional hernia, with an acceptable increase in operative time.
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Copyright (c) 2026 Mylena Santos Dantas, Soraia Barroso de Almeida , Fernando Ferreira Rios (Autor)
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