Comparison of Polypropylene Mesh and Small Bites Technique for Midline Laparotomy Closure in Emergency Colorectal Surgery to Prevent Incisional Hernia

What this Trial Is About

Researchers are investigating different methods to close the midline laparotomy incision in emergency colorectal surgery. The aim is to compare the use of a prophylactic polypropylene mesh with the "small bites" suture technique to see which approach better prevents incisional hernias and related complications. This study addresses a gap in current guidelines, which lack clear recommendations for emergency abdominal wall closure due to limited and varied existing evidence. The study includes two procedures: one group will have their incision closed using the "small bites" technique with a monofilament polydioxanone suture, without leaving a drainage system in the subcutaneous tissue. The other group will have the same "small bites" closure but with the addition of a partially absorbable low-density polypropylene mesh fixed with absorbable staples or sutures. Drainage systems and closure of the subcutaneous tissue will be managed based on surgical team discretion, especially if a diverting stoma is present. Participants will be adults undergoing urgent colorectal surgery via midline laparotomy or laparoscopic surgery converted to midline laparotomy. Researchers will track the incidence of incisional hernias over one year after surgery as the primary outcome. Safety and potential complications like wound infection will also be monitored. The study requires signed informed consent and involves ongoing follow-up to assess surgical outcomes and any hernia development.

Comparing Polypropylene Mesh and "Small Bites" Technique in Emergency Colorectal Surgery's Midline Laparotomy Closure. Study for Incisional Hernia Prevention.