Hernia prevention: practice patterns and surgeons' attitudes about abdominal wall closure and the use of prophylactic mesh

Abstract

Purpose: The penetration of hernia prevention techniques into surgical practice remains unknown.

Methods: A survey about knowledge/attitudes on hernia prevention was sent to the members of hernia societies.

Results: The 497 respondents were mostly from the US (47%) or Europe (40%). Most reported practicing, but not measuring their suture-to-wound length closure of > 4:1 (63%) and practicing but not measuring the number of stitches (58%). Reasons for not using short stitch closure were: does not apply to patient population (19%), not familiar enough with methods to correctly execute (25%), takes too long (13%), not reimbursed (4%), concerned about closure-related complications (27%), and other (22%). Regarding prophylactic mesh, respondents stated they were not familiar with literature (11%), familiar with literature but would not use (24%), familiar with literature and interested in use (45%), familiar with literature and using (15%), and other (5%).

Conclusions: There appears to be some application of hernia prevention principles related to fascial closure; however, the use of prophylactic mesh still appears to be controversial.

Keywords: Hernia; Laparotomy; Mesh; Prevention; Prophylactic.