World Journal of Surgery

, Volume 37, Issue 7, pp 1656–1660 | Cite as

Implantation of Prophylactic Nonabsorbable Intraperitoneal Mesh in Patients With Peritonitis Is Safe and Feasible

  • Anita Kurmann
  • Corina Barnetta
  • Daniel Candinas
  • Guido Beldi
Article

Abstract

Background

Patients with peritonitis undergoing emergency laparotomy are at increased risk for postoperative open abdomen and incisional hernia. This study aimed to evaluate the outcome of prophylactic intraperitoneal mesh implantation compared with conventional abdominal wall closure in patients with peritonitis undergoing emergency laparotomy.

Method

A matched case-control study was performed. To analyze a high-risk population for incisional hernia formation, only patients with at least two of the following risk factors were included: male sex, body mass index (BMI) >25 kg/m2, malignant tumor, or previous abdominal incision. In 63 patients with peritonitis, a prophylactic nonabsorbable mesh was implanted intraperitoneally between 2005 and 2010. These patients were compared with 70 patients with the same risk factors and peritonitis undergoing emergency laparotomy over a 1-year period (2008) who underwent conventional abdominal closure without mesh implantation.

Results

Demographic parameters, including sex, age, BMI, grade of intraabdominal infection, and operating time were comparable in the two groups. Incidence of surgical site infections (SSIs) was not different between groups (61.9 vs. 60.3 %; p = 0.603). Enterocutaneous fistula occurred in three patients in the mesh group (4.8 %) and in two patients in the control group (2.9 %; p = 0.667). The incidence of incisional hernia was significantly lower in the mesh group (2/63 patients) than in the control group (20/70 patients) (3.2 vs. 28.6 %; p < 0.001).

Conclusions

Prophylactic intraperitoneal mesh can be safely implanted in patients with peritonitis. It significantly reduces the incidence of incisional hernia. The incidences of SSI and enterocutaneous fistula formation were similar to those seen with conventional abdominal closure.

Notes

Conflict of interest

Drs. Anita Kurmann, Corina Barnetta, Daniel Candinas and Guido Beldi have no conflicts of interest or financial ties to disclose.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Anita Kurmann
    • 1
  • Corina Barnetta
    • 1
  • Daniel Candinas
    • 1
  • Guido Beldi
    • 1
  1. 1.Department of Visceral Surgery and MedicineInselspital, University Hospital of Bern, University of BernBernSwitzerland

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