Prophylactic Onlay Mesh Repair (POMR) Versus Primary Suture Repair (PSR) for Prevention of Incisional Hernia (IH) After Abdominal Wall Surgery: A Systematic Review and Meta-analysis

Hassan MA 1 , Yunus RM 2 , Khan S 3 , Memon MA 3

Affiliations 

  • 1 MAP Center for Urban Health Solutions, St. Michael's Hospital, 3rd floor, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada. [email protected]
  • 2 Institute of Mathematical Sciences, Faculty of Science, Universiti Malaya, Kuala Lumpur, Malaysia
  • 3 School of Sciences, Centre for Health Sciences Research, University of Southern Queensland, Toowoomba, QLD, Australia
World J Surg, 2021 10;45(10):3080-3091.
PMID: 34279690 DOI: 10.1007/s00268-021-06238-6

Abstract

BACKGROUND: With many different operative techniques in use to reduce the incidence of incisional hernias (IH) following a midline laparotomy, there is no consensus among the clinicians on the efficacy and safety of any particular repair technique. This meta-analysis compares the prophylactic onlay mesh repair (POMR) and primary suture repair (PSR) for the incidence of IH.

METHODS: A meta-analysis and systematic review of MEDLINE, PubMed Central (via PubMed), Embase (via Ovid), SCOPUS, ScienceDirect, Google Scholar, SCI and Cochrane Library databases were undertaken. Seven randomized controlled trials assessing the outcomes of PSR and POMR were analyzed in accordance with the PRISMA statement. The risk of bias was assessed using the Rob2 tool.

RESULTS: According to the pooled analysis, POMR significantly reduced the incidence of IH compared to the PSR (OR 5.82 [95% CI 2.69, 12.58] P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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