Peer-reviewed veterinary case report
Safety and effectiveness of mesh to prevent incisional hernia
By Lozada Hernandez EE et al.·2026·Hospital Regional de Alta Especialidad del Bajío·View original on Europe PMC →
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Original publication title: Efficacy and Safety of Prophylactic Mesh Reinforcement for the Prevention of Incisional Hernia: An Umbrella Review of Meta-Analyses.
Plain-English summary
This study looked at whether using a special mesh during surgery can help prevent incisional hernias, which are common complications that can happen after certain surgeries. The researchers found that using the mesh significantly lowers the chances of developing a hernia, but it also increases the risk of infections and fluid buildup at the surgery site. While the mesh seems to be effective in preventing hernias, the potential for complications means it should only be used in patients who are at high risk. Overall, the findings suggest that while the mesh can be helpful, careful consideration is needed to weigh the benefits against the risks.
Abstract
<h4>Introduction</h4>Incisional hernia (IH) is a frequent and expensive complication of laparotomy, occurring in up to 50% of high-risk patients. Although prophylactic mesh placement has been proposed as an effective preventive strategy of IH, its adoption remains limited due to concerns about mesh-related complications and the heterogeneity and variable quality of the available evidence. This umbrella meta-analysis aimed to synthesize the existing evidence to evaluate the efficacy and safety of prophylactic mesh reinforcement for IH prevention.<h4>Methods</h4>A systematic search of multiple databases was performed until June 2025 to identify meta-analyses comparing the use of prophylactic meshes versus primary closure in adults undergoing laparotomy. Methodological quality was assessed with the AMSTAR-2, and the data were reanalyzed with random or fixed effects models. Heterogeneity (I<sup>2</sup>), study overlap (CCA), publication bias, and robustness of the results were evaluated.<h4>Results</h4>Twenty-one meta-analyses were included. Prophylactic mesh reinforcement was associated with a significant reduction in the odds of incisional hernia (OR = 0.29; 95% CI: 0.22-0.38); this effect was consistent across different surgical settings. Mesh use was also associated with an increased risk of surgical site infection (OR = 1.17; 95% CI: 1.04-1.30) and seroma formation (OR = 2.31; 95% CI: 1.99-2.67). No significant differences were observed in abdominal wound dehiscence or hematoma. Overall, the evidence demonstrated a large and consistent effect, although substantial heterogeneity and signs of publication bias were present.<h4>Conclusion</h4>Prophylactic mesh reinforcement is associated with a reduced likelihood of incisional hernia but an increased risk of seroma and surgical site infection. Its use should be considered selectively in high-risk patients, balancing potential benefits against known complications. Further studies are needed to optimize patient selection and evaluate strategies to reduce mesh-related adverse outcomes, as well as to assess cost-effectiveness and quality-of-life outcomes.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41810389